Individual provider Active NPI

Jui-Li Chang, FNP

  • Family Nurse Practitioner
  • Saratoga, CA
National Provider Identifier
1821038068
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11837 Issued in CA
Practice address
13164 Kevin St
Saratoga, CA 95070-4613
Phone
(408) 379-1626
Fax
(408) 379-1626
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11837 CA Primary

Addresses

Primary practice location

13164 Kevin St
Saratoga, CA 95070-4613

Mailing address

13164 Kevin St
Saratoga, CA 95070-4613
Phone (408) 379-7416

Other practice location 1

734 Mowry Ave
Fremont, CA 94536-4115
Phone (510) 796-0770

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160825000533 CA Order and Referring Only - Nurse Practitioner 5395707277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11837CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fremont Internal Medicine Medical Associates,Inc PastSince Nov 20, 2006 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1821038068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13164 KEVIN ST",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950704613",
            "telephone_number": "408-379-7416",
            "fax_number": "408-379-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13164 KEVIN ST",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950704613",
            "telephone_number": "408-379-1626",
            "fax_number": "408-379-1626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "734 Mowry Ave",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945364115",
            "country_code": "US",
            "telephone_number": "510-796-0770",
            "fax_number": "510-796-7099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JUI-LI",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "11837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga, CA

Sources for this page

Verify at the official NPI Registry.