Individual provider Active NPI

Jonathan Nicolas Chang, M.D.

  • Anesthesiology Physician
  • Dallas, TX
National Provider Identifier
1720215601
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
Q2526 Issued in TX
Practice address
4500 S Lancaster Rd
Apms 112a
Dallas, TX 75216-7167
Phone
(214) 857-1931
NPI assigned
Jun 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2009014208 MO
Pain Medicine (Anesthesiology) Physician 207LP2900X 2011016776 MO
Anesthesiology Physician 207L00000X Q2526 TX Primary

Addresses

Primary practice location

4500 S Lancaster Rd
Apms 112a
Dallas, TX 75216-7167

Mailing address

PO Box 840853
Dallas, TX 75284-0853
Phone (972) 233-1999

Other practice location 1

12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Phone (972) 715-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160624000153 TX Practitioner - AnesthesiologyPractitioner - Pain Management 9234368705 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009014208MOMDAnesthesiology Physician
2011016776MOMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Anesthesiology CurrentSince Aug 1, 2016 Accepting new patients
U S Anesthesia Partners of Texas, PA Anesthesiology CurrentSince Nov 20, 2024 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Anesthesiology CurrentSince Nov 20, 2024 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 1, 2016 Accepting new patients

Locations

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

4500 S Lancaster Rd
#112A
Dallas, TX 75216
Phone (214) 226-8315

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 361-1844

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

12400 Dallas Pkwy
Frisco, TX 75033
Phone (469) 495-2000

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

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.

NPI Registry JSON

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1720215601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "address_2": "APMS 112A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167",
            "telephone_number": "214-857-1931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12222 Merit Dr Ste 600",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752513294",
            "country_code": "US",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JONATHAN",
        "middle_name": "NICOLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-17",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2009014208",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MO",
            "license": "2011016776",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "Q2526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.