Active NPI
Kevin W Chang, MD
- Pediatrics Physician
- Fresno, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A90847
- Practice address
- 7085 N Whitney Avenue
Suite 101
Fresno, CA 93720-8002 - Phone
- (559) 437-7338
- NPI assigned
- Jul 26, 2006
- Last updated
- Dec 19, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A90847 | CA | Primary |
Addresses
Primary practice location
7085 N Whitney Avenue
Suite 101
Fresno, CA 93720-8002
Mailing address
PO Box 28949
Fresno, CA 93729-8949
Phone (559) 228-4200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A908470 | Medicaid | CA | |
| A90847 | Other | CA | LICENSE |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Foundation Medical Group | Current | Accepting new patients | |
| Community Foundation Medical Group | Current | Accepting new patients | |
| Marvin P Matlock M D Inc | Past | Accepting new patients | |
| Community Medical Providers Medical Group Inc | Past | Accepting new patients |
Locations
681 N Medical Center Dr W
Ste 103
Clovis, CA 93611
Phone (559) 299-2200
1570 E Herndon Ave
Fresno, CA 93720
Phone (559) 437-7300
2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251
7085 N Whitney Ave
Ste 101
Fresno, CA 93720
Phone (559) 437-7338
7407 N Cedar Ave
Ste 102
Fresno, CA 93720
Phone (559) 369-4421
1429 N Acacia Ave
Reedley, CA 93654
Phone (559) 638-2522
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Sante' Foundation Medical Group
- Internal Medicine Physician
- Fresno, CA
- NPI 1811258510
-
dba Sante' Foundation Medical Group
- Orthopaedic Surgery Physician
- Fresno, CA
- NPI 1376056721
-
- Family Medicine Physician
- Fresno, CA
- NPI 1821075748
-
- Internal Medicine Physician
- Fresno, CA
- NPI 1346486396
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671408000000",
"number": "1760406789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 28949",
"city": "FRESNO",
"state": "CA",
"postal_code": "937298949",
"telephone_number": "559-228-4200",
"fax_number": "559-224-3920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7085 N WHITNEY AVENUE",
"address_2": "SUITE 101",
"city": "FRESNO",
"state": "CA",
"postal_code": "937208002",
"telephone_number": "559-437-7338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "KEVIN",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2022-12-19",
"certification_date": "2022-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A90847",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A908470",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "A90847",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.