Alice Chang, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD420531 Issued in PA

Practice address

Five Greentree Centre
525 Route 73 North Ste 104
Marlton, NJ 08053

Phone

(609) 200-0211

NPI assigned

Jan 5, 2007

Last updated

Jun 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2819/brand/1/csg/1/fhir/r4

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.

• Psych Choices of the Delaware Valley, LLC

  • Professional Counselor
  • Drexel Hill, PA
  • NPI 1194213892
  Medicare reassignment NPD
• West Phila Community Mental Health Consortium, Inc.

  dba The Consortium, Inc.

  • Counselor
  • Philadelphia, PA
  • NPI 1194757989
  Medicare reassignment NPD
• Alice Chang, MD LLC

  • Adult Mental Health Clinic/Center
  • Marlton, NJ
  • NPI 1083309793
  NPD Authorized official
• West Phila Community Mental Health Consortium, Inc.

  dba The Consortium, Inc.

  • Adult Mental Health Clinic/Center
  • Philadelphia, PA
  • NPI 1841319332
  NPD
• West Philadelphia Community MH Consortium Inc.

  dba The Consortium Inc.

  • Community/Behavioral Health Agency
  • Philadelphia, PA
  • NPI 1245350081
  NPD
• Jefferson University Physicians

  dba Jefferson GI

  • Gastroenterology Physician
  • Phila, PA
  • NPI 1205898723
  NPD (past)
• Mazzoni Center

  • Social Worker
  • Philadelphia, PA
  • NPI 1225188428
  NPD (past)
• Mazzoni Center

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1477631307
  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1811044373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 HADDON AVE UNIT 8774",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081088038",
            "telephone_number": "609-200-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FIVE GREENTREE CENTRE",
            "address_2": "525 ROUTE 73 NORTH STE 104",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "609-200-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "ALICE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2023-06-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD420531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101089739",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BETHANNA",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ines Cervantes
• Marvin A Cetel, M.D.
• Juliana Vocca Chakrabarti, MS, RD, CSP, LDN
• Brittany Chalfant, APN
• Sandra Chalik, MS OTR/L
• Andy Chang
• Changing Tides Wellness Center LLC
• Ramu Channamsetty, MD
• Rudolph Chao, DMD
• Charles M. Cummins, OD, PA

• Child & Adolescent Psychiatry Physician in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Child & Adolescent Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.

Verify at the official NPI Registry.