Active NPI
David Jin-Woo Chang, MD
- Neuroradiology Physician
- Vancouver, WA
National Provider Identifier
1861601791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuroradiology Physician
- License
- MD00048065
- Practice address
- 700 NE 87TH Ave
Vancouver, WA 98664 - Phone
- (360) 882-2778
- Fax
- (360) 604-1771
- NPI assigned
- May 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD00048065 | WA | |
| Diagnostic Radiology Physician | 2085R0202X | 2002014051 | MO | |
| Diagnostic Radiology Physician | 2085R0202X | 80245 | OR | |
| Neuroradiology Physician | 2085N0700X | MD00048065 | WA | Primary |
Addresses
Primary practice location
700 NE 87TH Ave
Vancouver, WA 98664
Mailing address
700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778
Other practice location 1
400 NE Mother Joseph Pl
Vancouver, WA 98664-3200
Phone (360) 514-2000
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0391698 | Other | WA | LNI-RADIA |
| 270199 | Medicaid | OR | |
| 1056120 | Medicaid | WA | |
| 1022554 | Medicaid | WA | |
| P00447671 | Other | OR | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Yale University School of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2002014051 | MO | MD | Diagnostic Radiology Physician |
| 80245 | OR | MD | Diagnostic Radiology Physician |
| MD00048065 | WA | MD | Diagnostic Radiology Physician |
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.
-
dba The Vancouver Clinic
- Internal Medicine Physician
- Vancouver, WA
- NPI 1992759427
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534291200000",
"number": "1861601791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 NE 87TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986641913",
"telephone_number": "360-882-2778",
"fax_number": "360-604-1771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 NE 87TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98664",
"telephone_number": "360-882-2778",
"fax_number": "360-604-1771"
}
],
"practiceLocations": [
{
"address_1": "400 NE Mother Joseph Pl",
"address_purpose": "LOCATION",
"city": "Vancouver",
"state": "WA",
"postal_code": "986643200",
"country_code": "US",
"telephone_number": "360-514-2000",
"fax_number": "360-514-6219",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHANG",
"first_name": "DAVID",
"middle_name": "JIN-WOO",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-21",
"last_updated": "2018-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WA",
"license": "MD00048065",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MO",
"license": "2002014051",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OR",
"license": "80245",
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "WA",
"license": "MD00048065",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LNI-RADIA",
"identifier": "0391698",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "270199",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1056120",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1022554",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00447671",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.