Individual provider Active NPI

Oliver Chang, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Miami, FL
National Provider Identifier
1790055291
Registry record updated Oct 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
ME116714 Issued in FL
Practice address
3659 S Miami Ave Ste 4002
Miami, FL 33133-4231
Phone
(305) 915-4663
Fax
(305) 675-5854
NPI assigned
Dec 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Q0888 TX
Student in an Organized Health Care Education/Training Program 390200000X
Plastic and Reconstructive Surgery Physician 2086S0122X ME116714 FL Primary

Addresses

Primary practice location

3659 S Miami Ave Ste 4002
Miami, FL 33133-4231

Mailing address

1300 S Miami Ave Unit 2301
Miami, FL 33130-4478
Phone (713) 859-5709

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
I20150518000922 TX Practitioner - Emergency Medicine 2466680996 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Frio Hospital Association CurrentSince May 5, 2014 Accepting new patients
Emergency Hospital Systems LLC CurrentSince Jul 3, 2017 Accepting new patients
Southwest Medical Associates, Inc. Emergency Medicine CurrentSince Mar 20, 2018 Accepting new patients
Jackson County Hospital District CurrentSince Oct 16, 2015 Accepting new patients
Frio Hospital Association Emergency Medicine CurrentSince May 5, 2014 Accepting new patients
Jackson County Hospital District Emergency Medicine CurrentSince Oct 16, 2015 Accepting new patients

Locations

1711 W Wheeler Ave
Aransas Pass, TX 78336
Phone (361) 758-0505

1017 S Travis Ave
Cleveland, TX 77327
Phone (281) 592-5400

1013 S Wells St
Edna, TX 77957
Phone (361) 782-5241

1416 George Dieter Dr
El Paso, TX 79936
Phone (877) 822-6281

8901 FM 1960 Bypass Rd W
Ste 105
Humble, TX 77338
Phone (281) 592-5400

151 Medical Dr
Pearsall, TX 78061
Phone (830) 334-4126

Organizations & group practices 6

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": "1325289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509408000000",
    "number": "1790055291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S MIAMI AVE UNIT 2301",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331304478",
            "telephone_number": "713-859-5709",
            "fax_number": "305-675-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3659 S MIAMI AVE STE 4002",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334231",
            "telephone_number": "305-915-4663",
            "fax_number": "305-675-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "OLIVER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-31",
        "last_updated": "2017-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q0888",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME116714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.