NPIMap

Individual provider Active NPI

Jen Chang, M.D.

  • Anesthesiology Physician
  • Salt Lake City, UT
National Provider Identifier
1922205848
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
9169318-1205 Issued in UT
Practice address
30 N 1900 E
RM 3C444
Salt Lake City, UT 84132-0002
Phone
(801) 581-6393
NPI assigned
Jul 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A97208 CA
Anesthesiology Physician 207L00000X 9169318-1205 UT Primary

Addresses

Primary practice location

30 N 1900 E
RM 3C444
Salt Lake City, UT 84132-0002

Mailing address

30 N 1900 E
RM 3C444
Salt Lake City, UT 84132-0002

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jchang103746@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20170510001384 UT Practitioner - Anesthesiology 2163745001 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millcreek Anesthesia PCGroup PAC ID 0840194643, 45 clinicians

Practice addresses (Care Compare)

11925 S State St
Draper, UT 84020-7735
Phone (801) 545-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

Merit-based Incentive Payment System (MIPS)

Final score
90.35 of 100Reported as group
Quality
72.06
Promoting interoperability
100
Improvement activities
40
Cost
72.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A97208CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Acuity Care Services CurrentSince Apr 18, 2017 Accepting new patients
University of Utah Acuity Care Services CurrentSince Apr 18, 2017 Accepting new patients
Millcreek Anesthesia PC Anesthesiology CurrentSince Feb 1, 2025 Accepting new patients
University of Utah Adult Services Anesthesiology CurrentSince Apr 18, 2017 Accepting new patients
University of Utah Adult Services CurrentSince Apr 18, 2017 Accepting new patients
University of Utah Adult Services Current Accepting new patients

Locations

11925 S State St
Draper, UT 84020
Phone (801) 545-8000

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

30 N 1900 E
Rm 3C444
Slc, UT 84132
Phone (801) 581-3622

1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111

Interoperability endpoints

  • Direct secure messaging: jchang103746@direct.med.utah.edu

Organizations & group practices 6

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 4

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1922205848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E",
            "address_2": "RM 3C444",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E",
            "address_2": "RM 3C444",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A97208",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "9169318-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jchang103746@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.