Individual provider Active NPI

Su Yeun Chang, NP-C

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1922764083
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95016668 Issued in CA
Practice address
100 UCLA Medical PLZ Ste 205
Los Angeles, CA 90024-6999
Phone
(310) 301-8707
Fax
(626) 986-4855
NPI assigned
Nov 12, 2021
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95016668 CA Primary

Addresses

Primary practice location

100 UCLA Medical PLZ Ste 205
Los Angeles, CA 90024-6999

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221026000373 CA Practitioner - Nurse Practitioner 5193191500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Medical Plaza
Los Angeles, CA 90095-0001

100 Medical PLZ
Suite 310
Los Angeles, CA 90095-0001
Phone (310) 825-7922

200 Medical Plaza
Los Angeles, CA 90095-0001

200 Medical PLZ
Los Angeles, CA 90095-0001

200 UCLA Medical PLZ
Suite 165 34
Los Angeles, CA 90095-0001
Phone (310) 824-8403

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

900 Weyburn Place
Suite 14 171
Los Angeles, CA 90095-0001
Phone (310) 825-8173

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95016668CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Sep 1, 2024 Accepting new patients
The Regents of the University of California CurrentSince Sep 1, 2024 Accepting new patients
UCLA Medical Group Past Accepting new patients
Jason S Paek MD,Inc PastSince Nov 1, 2021 Accepting new patients
Usc Care Medical Group, Inc PastSince Nov 1, 2021 Accepting new patients

Locations

24302 Paseo de Valencia
Ste 200
Laguna Hills, CA 92653
Phone (949) 458-8252

100 UCLA Medical Plz
Ste 205
Los Angeles, CA 90024
Phone (310) 208-5400

100 UCLA Medical Plz
Ste 345
Los Angeles, CA 90024
Phone (310) 206-6279

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 55737
Los Angeles, CA 90074

892 Aerovista Pl
Ste 240
San Luis Obispo, CA 93401
Phone (805) 541-8252

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500

Interoperability endpoints

  • Direct secure messaging: schang1271213@direct.uclahealth.org

Organizations & group practices 5

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 2

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": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1922764083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 UCLA MEDICAL PLZ STE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900246999",
            "telephone_number": "310-301-8707",
            "fax_number": "626-986-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "SU YEUN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-12",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95016668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.