NPIMap

Individual provider Active NPI

Carlos F Chang, M.D.

  • Internal Medicine Physician
  • Tavares, FL
National Provider Identifier
1922005016
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME71903 Issued in FL
Practice address
1862 Mayo Drive
Tavares, FL 32778
Phone
(352) 343-0053
Fax
(352) 343-0059
NPI assigned
Jul 5, 2005
Last updated
Mar 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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 ME71903 FL Primary

Addresses

Primary practice location

1862 Mayo Drive
Tavares, FL 32778

Mailing address

PO Box 1363
Mount Dora, FL 32756-1363
Phone (352) 343-0053

Other identifiers 1

IdentifierTypeStateIssuer
251269602MedicaidFL

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
I20041027000640 FL Practitioner - Internal Medicine 4981665684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Practice addresses (Care Compare)

1000 Waterman Way
Tavares, FL 32778-5266
Phone (352) 253-3333

1050 Old Camp Rd
Suite 282
The Villages, FL 32162-1762
Phone (352) 693-3378

1200 Lexington Green LN
Sanford, FL 32771-1013

1862 Mayo Dr
Tavares, FL 32778-4320
Phone (352) 343-0053

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME71903FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carlos Chang MD PA Internal Medicine CurrentSince Jul 1, 2004 Accepting new patients
Inphynet Contracting Services LLC Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

1862 Mayo Dr
Tavares, FL 32778
Phone (352) 343-0053

Interoperability endpoints

  • Direct secure messaging: cchang@carloschangmd.amazing-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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1922005016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1363",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327561363",
            "telephone_number": "352-343-0053",
            "fax_number": "352-343-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1862 MAYO DRIVE",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "32778",
            "telephone_number": "352-343-0053",
            "fax_number": "352-343-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "CARLOS",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME71903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251269602",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.