Individual provider Active NPI

Edwin Yao-Yuan Chang, MD

  • Plastic and Reconstructive Surgery Physician
  • Mount Vernon, WA
National Provider Identifier
1700908019
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
MD00049137 Issued in WA
Practice address
1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone
(360) 428-2586
Fax
(360) 428-6470
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MD00049137 WA
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X MD00049137 WA
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X MD00049137 WA
Plastic and Reconstructive Surgery Physician 2086S0122X MD00049137 WA Primary

Addresses

Primary practice location

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Mailing address

1400 E Kincaid St
Attn: Credentialing
Mount Vernon, WA 98274-4127
Phone (360) 428-2500

Other identifiers 4

IdentifierTypeStateIssuer
0261838OtherWALABOR & INDUSTRIES
0261838OtherWAVICTIM'S OF CRIM
170090819MedicaidWA
P00840095OtherMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20080402000889 WA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 1557448495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
University of Michigan Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Practice addresses (Care Compare)

1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone (360) 428-2500

1415 E Kincaid St
Mount Vernon, WA 98274-4126
Phone (360) 416-5750

211 S 13TH St
Mount Vernon, WA 98274-4107
Phone (360) 814-5900

Hospital & facility affiliations

  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision116
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit CurrentSince Aug 31, 2013 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Aug 31, 2013 Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients
Spokane Plastic Surgeons PS Plastic Surgery Past Accepting new patients

Locations

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

Interoperability endpoints

  • Direct secure messaging: echang15627@skagit.direct-ci.com

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 1

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1700908019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "address_2": "ATTN: CREDENTIALING",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-428-2500",
            "fax_number": "360-428-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-428-2586",
            "fax_number": "360-428-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "EDWIN",
        "middle_name": "YAO-YUAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WA",
            "license": "MD00049137",
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "WA",
            "license": "MD00049137",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "WA",
            "license": "MD00049137",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "WA",
            "license": "MD00049137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0261838",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VICTIM'S OF CRIM",
            "identifier": "0261838",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170090819",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00840095",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.