NPIMap

Individual provider Active NPI

Khai Sheng Chang, MD

  • Internal Medicine Physician
  • Mount Dora, FL
National Provider Identifier
1881665222
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME75650 Issued in FL
Practice address
18550 US Highway 441
Mount Dora, FL 32757-6725
Phone
(352) 735-3755
Fax
(352) 735-3151
NPI assigned
Feb 1, 2006
Last updated
Jan 11, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME75650 FL Primary

Addresses

Primary practice location

18550 US Highway 441
Mount Dora, FL 32757-6725

Mailing address

10250 SE 167TH Place Rd Unit 5
Summerfield, FL 34491-8682
Phone (352) 307-9225

Other identifiers 1

IdentifierTypeStateIssuer
021830200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100713000158 FL Practitioner - Internal Medicine 7911973722 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeview Healthcare System, LLCGroup PAC ID 8921074733, 25 clinicians

Practice addresses (Care Compare)

10250 SE 167TH Place Rd
Unit 5
Summerfield, FL 34491-8682
Phone (352) 307-9925

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Healthcare System, LLC CurrentSince Jul 19, 2001 Accepting new patients
Physicians of Central Florida PA Internal Medicine CurrentSince May 27, 2003 Accepting new patients
Lakeview Healthcare System, LLC Internal Medicine CurrentSince Jul 19, 2001 Accepting new patients
Physicians of Central Florida, LLC Internal Medicine CurrentSince May 1, 2004 Accepting new patients
Mount Dora Family Practice PA PastSince Sep 16, 2016 Accepting new patients
Lakeview Internal Medicine P.a. Internal Medicine Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1801 US Highway 441
Bldg 100
Leesburg, FL 34748
Phone (352) 314-1989

18550 US Highway 441
Mount Dora, FL 32757
Phone (352) 735-3755

18550 US Highway 441
Ste A
Mount Dora, FL 32757
Phone (352) 735-3755

10250 SE 167th Place Rd
Unit 5
Summerfield, FL 34491
Phone (352) 307-9225

910 Old Camp Rd
Ste 202
The Villages, FL 32162
Phone (352) 350-2297

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kchang562480@direct.shands.ufl.edu

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Weirsdale Family Health Center IncWeirsdale, FL, CCN 108934 Rural health clinic 5% Or Greater Direct Ownership Interest (16.6%) Aug 1, 2012
Louis J Radnothy DO PAUmatilla, FL, CCN 103901 Rural health clinic 5% Or Greater Direct Ownership Interest (16.6%)
General Partnership Interest		 Aug 1, 2012
Aug 1, 2012

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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 5

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1881665222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10250 SE 167TH PLACE RD UNIT 5",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344918682",
            "telephone_number": "352-307-9225",
            "fax_number": "352-307-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18550 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576725",
            "telephone_number": "352-735-3755",
            "fax_number": "352-735-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "KHAI",
        "middle_name": "SHENG",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME75650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021830200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

Verify at the official NPI Registry.