Active NPI
Grace C Chang, MD
- Anesthesiology Physician
- Santa Monica, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- A95514
- Practice address
- 2121 Santa Monica Blvd
Santa Monica, CA 90404 - Phone
- (310) 829-5511
- NPI assigned
- Jun 20, 2006
- Last updated
- Jan 3, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | A95514 | CA | Primary |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | A95514 | CA |
Addresses
Primary practice location
2121 Santa Monica Blvd
Santa Monica, CA 90404
Mailing address
2708 Wilshire Blvd # 248
Santa Monica, CA 90403-4706
Other practice location 1
1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122
Phone (925) 947-3779
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: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Boston University School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1328 22ND St
St Johns Hospital
Santa Monica, CA 90404-2091
Phone (310) 477-2465
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A95514 | CA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bayside Anesthesia Medical Group | Pain Medicine | Current | Accepting new patients |
Locations
1328 22nd St
Santa Monica, CA 90404
Phone (310) 829-5511
2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pain Medicine (Anesthesiology) Physician
- Santa Monica, CA
- NPI 1184668469
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Santa Monica, CA
- NPI 1124026273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546473600000",
"number": "1720024789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2708 WILSHIRE BLVD # 248",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904034706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 SANTA MONICA BLVD",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "90404",
"telephone_number": "310-829-5511"
}
],
"practiceLocations": [
{
"address_1": "1601 Ygnacio Valley Rd",
"address_purpose": "LOCATION",
"city": "Walnut Creek",
"state": "CA",
"postal_code": "945983122",
"country_code": "US",
"telephone_number": "925-947-3779",
"fax_number": "925-947-3291",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHANG",
"first_name": "GRACE",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-20",
"last_updated": "2019-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "A95514",
"primary": true
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "CA",
"license": "A95514",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.