NPIMap

Individual provider Active NPI

Connie Youhua Chang, M.D.

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1629192125
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
231040 Issued in MA
Practice address
55 Fruit St
Yawkey 6E
Boston, MA 02114-2621
Phone
(617) 726-7717
NPI assigned
Mar 19, 2007
Last updated
Feb 4, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 231040 MA Primary

Addresses

Primary practice location

55 Fruit St
Yawkey 6E
Boston, MA 02114-2621

Mailing address

55 Fruit St
Yawkey 6E
Boston, MA 02114-2621
Phone (617) 726-7717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110802000030 MA Practitioner - Diagnostic Radiology 4385813732 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
231040MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Jul 1, 2011 Accepting new patients
Mass General Brigham Medical Group Western Massachusetts Inc CurrentSince May 1, 2022 Accepting new patients
Cooley Dickinson Hospital Inc Current Accepting new patients
General Hospital Corp Current Accepting new patients
Hampshire Pathologists, Inc. Current Accepting new patients
Massachusetts General Physicians Organization Inc Diagnostic Radiology CurrentSince Jul 1, 2011 Accepting new patients
Cooley Dickinson Hospital Inc CurrentSince May 1, 2022 Accepting new patients
Mass General Brigham Medical Group Western Massachusetts Inc Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
#6E
Boston, MA 02114
Phone (617) 726-7717

30 Locust St
Northampton, MA 01060
Phone (413) 582-2000

12 College Hwy
Southampton, MA 01073
Phone (413) 527-1105

Interoperability endpoints

  • Direct secure messaging: chang.connie.mgh@direct.partners.masshiway.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359936000000",
    "number": "1629192125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "YAWKEY 6E",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "YAWKEY 6E",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "CONNIE",
        "middle_name": "YOUHUA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2013-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "231040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.