Individual provider Active NPI

Charles Y Chang, MD

  • Urology Physician
  • Concord, CA
National Provider Identifier
1942436886
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
C166684 Issued in CA
Practice address
2222 East St Ste 250
Concord, CA 94520-2096
Phone
(925) 609-7220
NPI assigned
Jun 5, 2009
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X C166684 CA Primary
Urology Physician 208800000X MD60462997 WA
Urology Physician 208800000X 125054599 IL
Urology Physician 208800000X 314844 NY

Addresses

Primary practice location

2222 East St Ste 250
Concord, CA 94520-2096

Mailing address

1450 Treat Blvd Ste 300
Walnut Creek, CA 94597-2168
Phone (925) 952-2828

Other practice location 1

3124 S 19th St # 320
Tacoma, WA 98405-2433
Phone (253) 301-5100

Other practice location 2

199 Mount Eden Pkwy
Bronx, NY 10457-7703
Phone (718) 992-7669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NY, CA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20140916002944 WA Practitioner - Urology 1850510207 Reassigns benefits to 1 organization
I20220311001126 NY Practitioner - Urology 1850510207 Reassigns benefits to 1 organization
I20241219002098 CA Practitioner - Urology 1850510207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
John Muir Physician NetworkGroup PAC ID 6608789813, 488 clinicians

Practice addresses (Care Compare)

2222 E St
Suite 250
Concord, CA 94520-2096
Phone (925) 609-7220

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C166684CAMDUrology Physician
125054599ILMDUrology Physician
MD60462997WAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Mar 1, 2022 Accepting new patients
Multicare Health System CurrentSince Aug 25, 2014 Accepting new patients
Multicare Health System CurrentSince Aug 25, 2014 Accepting new patients
Multicare Health System Current Accepting new patients
Bronxcare Health System CurrentSince Mar 1, 2022 Accepting new patients
John Muir Physician Network CurrentSince Jan 16, 2024 Accepting new patients
Bronxcare Health System Past Accepting new patients

Locations

2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112

2222 East St
Ste 250
Concord, CA 94520
Phone (925) 609-7220

380 Civic Dr
Ste 100
Pleasant Hill, CA 94523
Phone (925) 284-3840

1450 Treat Blvd
Ste 300
Walnut Creek, CA 94597

1276 Fulton Ave
Rm 219
Bronx, NY 10456

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

3124 S 19th St
#320
Tacoma, WA 98405
Phone (253) 301-5100

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Interoperability endpoints

  • Direct secure messaging: cchang178165@ehr.johnmuirhealth.com

Organizations & group practices 7

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": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1942436886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 TREAT BLVD STE 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972168",
            "telephone_number": "925-952-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 EAST ST STE 250",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202096",
            "telephone_number": "925-609-7220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3124 S 19th St # 320",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984052433",
            "country_code": "US",
            "telephone_number": "253-301-5100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "199 Mount Eden Pkwy",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104577703",
            "country_code": "US",
            "telephone_number": "718-992-7669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "CHARLES",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-05",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "C166684",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD60462997",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "125054599",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "314844",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.