NPIMap

Individual provider Active NPI

Mark K Chang, M.D.

  • Orthopaedic Surgery Physician
  • Dyer, IN
National Provider Identifier
1871607507
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036095817 Issued in IL
Practice address
1100 Joliet St
Ste 104
Dyer, IN 46311-1996
Phone
(219) 836-4955
Fax
(219) 865-2377
NPI assigned
Aug 19, 2006
Last updated
Feb 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 200033540A IN
Orthopaedic Surgery Physician 207X00000X 036095817 IL Primary

Addresses

Primary practice location

1100 Joliet St
Ste 104
Dyer, IN 46311-1996

Mailing address

1100 Joliet St
Ste 104
Dyer, IN 46311-1996
Phone (219) 836-4955

Other identifiers 3

IdentifierTypeStateIssuer
P00419910OtherRAILROAD MEDICARE
036095817MedicaidIL
200868870AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20050404000169 IL Practitioner - Orthopedic Surgery 4981651882 Practice locations: Hazel Crest, IL
I20070702000136 IN Practitioner - Orthopedic Surgery 4981651882 Practice locations: Dyer, IN; Munster, IN
O20100930082604 IN DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0547369613 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dyer, IN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Medical University of South Carolina College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1100 Joliet St
Dyer, IN 46311-1995
Phone (219) 836-4955

17800 Kedzie Ave
Hazel Crest, IL 60429-2029
Phone (708) 799-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.02 of 100Reported as apm
Quality
85.37
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion529
Laminectomy or laminotomy (partial removal of spine bones)213
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036095817ILMDOrthopaedic Surgery Physician
200033540AINMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Orthopedic Specialists S C Orthopaedic Surgery PastSince Feb 1, 2008 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: midwestspinecare.markchang@114152.advancedmd-direct.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1871607507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 JOLIET ST",
            "address_2": "STE 104",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111996",
            "telephone_number": "219-836-4955",
            "fax_number": "219-865-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JOLIET ST",
            "address_2": "STE 104",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111996",
            "telephone_number": "219-836-4955",
            "fax_number": "219-865-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "MARK",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "200033540A",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036095817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00419910",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095817",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200868870A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyer, IN

Sources for this page

Verify at the official NPI Registry.