Individual provider Active NPI

Steven Chang

  • Optometrist
  • New York, NY
National Provider Identifier
1710415674
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV008654 Issued in NY
Practice address
33 W 42ND St
New York, NY 10036-8005
Phone
(212) 938-4001
NPI assigned
May 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT33871-TLG CA
Optometrist 152W00000X TUV008654 NY Primary

Addresses

Primary practice location

33 W 42ND St
New York, NY 10036-8005

Mailing address

43 Brooklyn Ave
6A
Brooklyn, NY 11216-5049

Other practice location 1

760 Broadway
Brooklyn, NY 11206-5317
Phone (718) 963-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181105002823 CA Practitioner - Optometry 6103190442 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT33871-TLGCAMDOptometrist
TUV008654NYMDOptometrist
008654NYMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall B. Ketchum University Optometrist Current Accepting new patients
Children'S Hospital Los Angeles Medical Group, Inc. CurrentSince Aug 26, 2018 Accepting new patients
Marshall B. Ketchum University CurrentSince Aug 15, 2022 Accepting new patients

Locations

5460 E La Palma Ave
Anaheim, CA 92807
Phone (714) 463-7500

3916 S Broadway
Los Angeles, CA 90037
Phone (323) 234-9137

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

3701 Wilshire Blvd
Ste 600
Los Angeles, CA 90010
Phone (323) 361-3550

Interoperability endpoints

  • Direct secure messaging: steven.chang.p1@direct.ezramedical.nextgenshare.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1710415674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 BROOKLYN AVE",
            "address_2": "6A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112165049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W 42ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368005",
            "telephone_number": "212-938-4001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Broadway",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112065317",
            "country_code": "US",
            "telephone_number": "718-963-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT33871-TLG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.