Individual provider Active NPI

Irene L Chang, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Wichita, KS
National Provider Identifier
1649450099
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
0435543 Issued in KS
Practice address
929 N Saint Francis
Wichita, KS 67214-3821
Phone
(316) 268-5426
Fax
(316) 652-0340
NPI assigned
Nov 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A96577 CA
Anatomic Pathology Physician 207ZP0101X ML 60095805 WA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 0435543 KS Primary

Addresses

Primary practice location

929 N Saint Francis
Wichita, KS 67214-3821

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Other identifiers 1

IdentifierTypeStateIssuer
200859940AMedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120416000167 KS Practitioner - PathologyPractitioner - Diagnostic Radiology 0749305266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcentral Pathology Laboratory, PAGroup PAC ID 5799759122, 10 clinicians

Practice addresses (Care Compare)

3600 E Harry
Wichita, KS 67201-3713
Phone (316) 268-5426

3600 E Harry St
Wichita, KS 67218-3713

4174 S Oliver St
BLDG 174H
Wichita, KS 67210-2142
Phone (316) 978-8600

929 N St Francis
Wichita, KS 67214-3821
Phone (316) 268-5426

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.23 of 100Reported as group
Quality
82.45
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ML 60095805WAMDAnatomic Pathology Physician
A96577CAMDAnatomic Pathology & Clinical Pathology Physician
0435543KSMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southcentral Pathology Laboratory, PA Anatomic Pathology & Clinical Pathology CurrentSince Apr 1, 2012 Accepting new patients

Locations

929 N Saint Francis Ave
Wichita, KS 67214
Phone (316) 291-4396

3600 E Harry St
Wichita, KS 67218
Phone (316) 268-5426

5700 Southwyck Blvd
Toledo, OH 43614

Organizations & group practices 1

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

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": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1649450099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 N SAINT FRANCIS",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143821",
            "telephone_number": "316-268-5426",
            "fax_number": "316-652-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "IRENE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A96577",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "WA",
            "license": "ML 60095805",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KS",
            "license": "0435543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200859940A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.