Individual provider Active NPI

Jodie Chang, MD

  • Diagnostic Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1831629260
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2019009744 Issued in MO
Practice address
510 S Kingshighway Blvd
Dept Radiology
Saint Louis, MO 63110-1016
Phone
(314) 362-7200
Fax
(314) 747-4189
NPI assigned
Jun 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2019009744 MO Primary

Addresses

Primary practice location

510 S Kingshighway Blvd
Dept Radiology
Saint Louis, MO 63110-1016

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-7200

Other identifiers 1

IdentifierTypeStateIssuer
200063042MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220628000307 MO Practitioner - Diagnostic Radiology 6608107867 Reassigns benefits to 6 organizations
I20230831004855 WA Practitioner - Diagnostic Radiology 6608107867 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

121 Stewart St
Apt 2307
Seattle, WA 98101-1130
Phone (314) 362-7200

510 S Kingshighway Blvd
Saint Louis, MO 63110-1016
Phone 31436272001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019009744MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BJC Outpatient Imaging LLC Diagnostic Radiology CurrentSince Feb 1, 2026 Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Aug 16, 2022 Accepting new patients
Union Avenue Open MRI LLC CurrentSince Aug 16, 2022 Accepting new patients
Tra-Minw P S CurrentSince Jul 2, 2022 Accepting new patients
Washington University Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
The Carol Milgard Breast Center CurrentSince May 3, 2023 Accepting new patients
Miracl, LLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

1785 Clarkson Rd
Chesterfield, MO 63017
Phone (636) 681-1540

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

510 S Kingshighway Blvd
Saint Louis, MO 63110
Phone (314) 362-0177

660 S Euclid Ave
#8131
Saint Louis, MO 63110
Phone (314) 362-2809

660 S Euclid Ave
Saint Louis, MO 63110

510 S Kingshighway Blvd
#8131
Saint Louis, MO 63110
Phone (314) 362-2900

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

222 15th Ave SE
Puyallup, WA 98372

3402 S 18th St
Tacoma, WA 98405
Phone (253) 383-1099

2502 S Union Ave
Tacoma, WA 98405
Phone (253) 759-5900

4525 S 19th St
Tacoma, WA 98405
Phone (253) 759-2622

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1831629260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S KINGSHIGHWAY BLVD",
            "address_2": "DEPT RADIOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101016",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JODIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2019009744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200063042",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "510 S Kingshighway Blvd",
            "address_2": "Dept Radiology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.