Active NPI
Liza Waichun Chang, M.D.
- MOHS-Micrographic Surgery Physician
- Towson, MD
National Provider Identifier
1932164100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- MOHS-Micrographic Surgery Physician
- License
- D45873
- Practice address
- 515 Fairmount Ave Ste 340
Towson, MD 21286-8522 - Phone
- (410) 321-9108
- Fax
- (410) 321-9126
- NPI assigned
- Apr 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| MOHS-Micrographic Surgery Physician | 207ND0101X | D45873 | MD | Primary |
Addresses
Primary practice location
515 Fairmount Ave Ste 340
Towson, MD 21286-8522
Mailing address
515 Fairmount Ave Ste 400
Towson, MD 21286-8518
Phone (410) 494-1355
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 122611900 | Medicaid | MD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | liza.chang.p2@direct.clinicalassociates.nextgenshare.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinical Associates P a | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Ambulatory Surgical Clinic/Center
- Towson, MD
- NPI 1982074001
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1932164100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 FAIRMOUNT AVE STE 400",
"city": "TOWSON",
"state": "MD",
"postal_code": "212868518",
"telephone_number": "410-494-1355",
"fax_number": "410-494-1361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 FAIRMOUNT AVE STE 340",
"city": "TOWSON",
"state": "MD",
"postal_code": "212868522",
"telephone_number": "410-321-9108",
"fax_number": "410-321-9126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "LIZA",
"middle_name": "WAICHUN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-19",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "207ND0101X",
"taxonomy_group": "",
"desc": "Dermatology, MOHS-Micrographic Surgery",
"state": "MD",
"license": "D45873",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "122611900",
"state": "MD"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "liza.chang.p2@direct.clinicalassociates.nextgenshare.com",
"affiliation": "N",
"address_1": "515 Fairmount Ave Ste 340",
"city": "Towson",
"state": "MD",
"country_code": "US",
"postal_code": "212868522",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Towson, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.