NPIMap

Individual provider Active NPI

Ku-Juey Raymond Chang, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Lake Forest, CA
National Provider Identifier
1689611337
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
G181497 Issued in CA
Practice address
23331 El Toro Rd
Suite 102
Lake Forest, CA 92630-4891
Phone
(949) 916-9100
Fax
(949) 916-0091
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X G181497 CA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X G181497 CA Primary

Addresses

Primary practice location

23331 El Toro Rd
Suite 102
Lake Forest, CA 92630-4891

Mailing address

PO Box 511345
Los Angeles, CA 90051-7900
Phone (916) 949-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050331001049 CA Practitioner - Nephrology 6406802693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Minnesota Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scke IncGroup PAC ID 6608822895, 20 clinicians

Practice addresses (Care Compare)

23141 Moulton Pkwy
Suite 102
Laguna Hills, CA 92653-1241
Phone (949) 916-9100

Hospital & facility affiliations

  • DaVita Saddleback Dialysis Dialysis facility, Laguna Hills, CA, CCN 052808
  • DaVita San Juan Capistrano South Dialysis Dialysis facility, San Juan Capistrano, CA, CCN 052648
  • Healthways Home Health Services, Inc Home health agency, Irvine, CA, CCN 059219
  • Care Plus Home Health Home health agency, Laguna Hills, CA, CCN 059376
  • Doctor'S Preferred Home Health Care Inc Home health agency, Temecula, CA, CCN 559277
  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603
  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81497CAMDPharmacist
G181497CAMDNephrology Physician

Practice roles (4 of 5)

OrganizationSpecialtyStatusNew patients
Scke, Inc Endocrinology, Diabetes & Metabolism CurrentSince Jan 26, 2005 Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
United Medical Doctors Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients

Locations

22 Odyssey
Ste 115
Irvine, CA 92618
Phone (949) 988-7550

23141 Moulton Pkwy
Ste 102
Laguna Hills, CA 92653
Phone (949) 916-9100

23331 El Toro Rd
Ste 102
Lake Forest, CA 92630
Phone (949) 633-8189

655 Camino de los Mares
#12
San Clemente, CA 92673
Phone (949) 916-9100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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 8

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1689611337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511345",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900517900",
            "telephone_number": "916-949-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23331 EL TORO RD",
            "address_2": "SUITE 102",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304891",
            "telephone_number": "949-916-9100",
            "fax_number": "949-916-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "KU-JUEY RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G181497",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "G181497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

Verify at the official NPI Registry.