Centerhealth Medical PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CENTERHEALTH MEDICAL PLLC

Practice address

3808 Union St Ste 3K
Flushing, NY 11354-5670

Phone

(718) 578-1318

NPI assigned

Jun 30, 2019

Organization subpart

No

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

Authorized official

Name

Wan Tan Chang, MDNPI 1174866859

Title

Manager

Phone

(718) 578-1318

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wan Tan Chang, M.D.

  • Family Medicine Physician
  • Flushing, NY
  • NPI 1174866859
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1561852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561852800000",
    "number": "1710549779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14000 E 980 NORTH RD",
            "city": "GEORGETOWN",
            "state": "IL",
            "postal_code": "618467511",
            "telephone_number": "718-578-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 UNION ST STE 3K",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545670",
            "telephone_number": "718-578-1318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERHEALTH MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-30",
        "last_updated": "2019-06-30",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "WAN TAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-578-1318",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cely Cen He, RD, CDN
• Jenny Cen
• Angela Centeno Gavica, DO
• Jerry Noel Centeno, M.D.
• Center for Learning and Growth Health and Wellness Services, LLC
• Centerlight Healthcare, Inc
• Centerlight Healthcare, Inc.
• Centerlight Healthcare, Inc.
• Central Ipa Inc
• Central Radiology, PC

• Family Medicine Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.