Individual provider Active NPI

Catherine S. Chang, MD

  • Plastic Surgery Physician
  • Beverly Hills, CA
National Provider Identifier
1851684062
Registry record updated Dec 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A156372 Issued in CA
Practice address
436 N Bedford Dr Ste 103
Beverly Hills, CA 90210-4323
Phone
(310) 278-8200
Fax
(310) 278-8230
NPI assigned
May 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X MT199700 PA
Student in an Organized Health Care Education/Training Program 390200000X MT199700 PA
Plastic Surgery Physician 208200000X A156372 CA Primary

Addresses

Primary practice location

436 N Bedford Dr Ste 103
Beverly Hills, CA 90210-4323

Mailing address

436 N Bedford Dr Ste 103
Beverly Hills, CA 90210-4323
Phone (310) 278-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190328000197 CA Practitioner - Plastic and Reconstructive Surgery 7618248295 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A156372CAMDPlastic Surgery Physician
MT199700PAMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cassileth Reconstructive Surgeons, Inc Plastic and Reconstructive Surgery CurrentSince Aug 8, 2018 Accepting new patients

Locations

436 N Bedford Dr
Ste 103
Beverly Hills, CA 90210
Phone (310) 247-1900

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": "1305849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1851684062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 N BEDFORD DR STE 103",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104323",
            "telephone_number": "310-278-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 N BEDFORD DR STE 103",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104323",
            "telephone_number": "310-278-8200",
            "fax_number": "310-278-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "CATHERINE",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-20",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "PA",
            "license": "MT199700",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT199700",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A156372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.