NPIMap

Individual provider Active NPI

Jonathan Chang

  • Colon & Rectal Surgery Physician
  • Bloomfield, CT
National Provider Identifier
1861924755
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
80291 Issued in CT
Practice address
6 Northwestern Dr Ste 305
Bloomfield, CT 06002-3428
Phone
(860) 242-8591
Fax
(860) 242-2511
NPI assigned
Mar 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 80291 CT Primary

Addresses

Primary practice location

6 Northwestern Dr Ste 305
Bloomfield, CT 06002-3428

Mailing address

263 Farmington Ave
Farmington, CT 06030-1921

Other practice location 1

2400 Tamarack Ave Ste 200
South Windsor, CT 06074-5559
Phone (860) 242-8591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250724003895 CT Practitioner - Colorectal Surgery (Proctology) 0345511739 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Tufts University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colon and Rectal Surgeons of Greater Hartford LLCGroup PAC ID 0244223956, 9 clinicians

Practice addresses (Care Compare)

6 Northwestern Dr
Suite 305
Bloomfield, CT 06002-3428
Phone (860) 242-8591

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Colon and Rectal Surgeons of Greater Hartford, LLC Colon & Rectal Surgery CurrentSince Sep 1, 2025 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Feb 1, 2026 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Feb 1, 2026 Accepting new patients

Locations

6 Northwestern Dr
Ste 305
Bloomfield, CT 06002
Phone (860) 242-8591

580 Cottage Grove Rd
Ste 211
Bloomfield, CT 06002
Phone (860) 242-2193

263 Farmington Ave
#8073
Farmington, CT 06030
Phone (860) 679-3467

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

2400 Tamarack Ave
Ste 100
South Windsor, CT 06074
Phone (860) 644-7336

2400 Tamarack Ave
Ste 200
South Windsor, CT 06074
Phone (860) 242-8591

1000 Asylum Ave
Ste 4302
West Hartford, CT 06105
Phone (860) 714-4270

Interoperability endpoints

  • Direct secure messaging: jchang3562714@direct.trinity-health.org

Organizations & group practices 3

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1861924755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060301921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 NORTHWESTERN DR STE 305",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023428",
            "telephone_number": "860-242-8591",
            "fax_number": "860-242-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Tamarack Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "South Windsor",
            "state": "CT",
            "postal_code": "060745559",
            "country_code": "US",
            "telephone_number": "860-242-8591",
            "fax_number": "860-242-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-30",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "CT",
            "license": "80291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

Verify at the official NPI Registry.