Keith C. Chang, MD, PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

193442 Issued in NY

Legal business name

KEITH C. CHANG, MD, PLLC

Practice address

217 Grand St
Suite 302
New York, NY 10013-4286

Phone

(212) 965-8883

Fax

(212) 965-8878

NPI assigned

Jun 11, 2007

Last updated

Nov 3, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Keith Chang, MDNPI 1588703995

Title

Physician in Charge

Phone

(212) 965-8883

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Tax ID family

Keith C Chang MD PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Keith C Chang MD PLLC

  • Clinic/Center
  • Brooklyn, NY
  • NPI 1164762449
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keith C Chang, MD

  • Ophthalmology Physician
  • New York, NY
  • NPI 1588703995
  Medicare reassignment NPD Authorized official
• Candice Haoyu Meng, OD

  • Optometrist
  • Flushing, NY
  • NPI 1023635208
  NPD
• Ying Liu, OD

  • Optometrist
  • Chula Vista, CA
  • NPI 1508116955
  NPD

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194048000000",
    "number": "1851595383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1240",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "102761240",
            "telephone_number": "212-965-8883",
            "fax_number": "212-965-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 GRAND ST",
            "address_2": "SUITE 302",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134286",
            "telephone_number": "212-965-8883",
            "fax_number": "212-965-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH C. CHANG, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2007-11-03",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PHYSICIAN IN CHARGE",
        "authorized_official_telephone_number": "212-965-8883",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "193442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01629038",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronit Keisari, M.D.
• Aminata Keita
• Fatoumata Keita
• Stella Bracco Keitel, PSY.D.
• Keith Berkowitz M.D. P.C.
• Keith M. Blechman, M.D., P.C. (Breast Surgery Group)
• Keith P, Johnson, M.D., PLLC
• Keith R. Brunckhorst M.D. P.C.
• Keith Siller MD
• Jana Keith-Jennings

• Ophthalmology Physician in New York, NY
• Providers in New York, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.