Ethan Chang

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT43453 Issued in FL

Practice address

611 W Lumsden Rd
Brandon, FL 33511-5911

Phone

(813) 413-5513

Fax

(844) 757-3726

NPI assigned

Aug 11, 2025

Last updated

Mar 2, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Optimal Performance and Physical Therapies-Brandon LLCGroup PAC ID 7214104587, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Ohi West Medical Group, LLC

  dba Bayfront Health St. Petersburg Medical Group

  • Cardiovascular Disease Physician
  • St Petersburg, FL
  • NPI 1518572551
  Medicare reassignment Care Compare group NPD
• Optimal Performance and Physical Therapies-Brandon LLC

  • Physical Therapist
  • Brandon, FL
  • NPI 1407132632
  Medicare reassignment Care Compare group NPD
• Orlando Health Medical Group Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1669429577
  Medicare reassignment NPD
• Ohi West Medical Group, LLC

  dba Bayfront Health St. Petersburg Imaging Center

  • Radiology Clinic/Center
  • St Petersburg, FL
  • NPI 1285240192
  NPD
• Orlando Health Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Winter Park, FL
  • NPI 1265019541
  NPD

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

{
    "created_epoch": "1754870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1952286601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W LUMSDEN RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115911",
            "telephone_number": "813-413-5513",
            "fax_number": "844-757-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W LUMSDEN RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115911",
            "telephone_number": "813-413-5513",
            "fax_number": "844-757-3726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 W Lumsden Rd",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335115911",
            "country_code": "US",
            "telephone_number": "813-413-5513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "ETHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-11",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT43453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zayda Chamorro, M.D.
• Champion Wellness Centers, Fishhawk, LLC (Brandon Spine and Injury)
• Natasha Jeanette Champion, M.D.
• Rebecca Lee Fitzgerald Champion
• Melissa Chandler, M.A., C.C.C.
• Michael Chanthalangsy, DDS
• Christina Chanthanivong, DO
• Charles Devine, M.D., P.a.
• Charles Lawrence Allen, Inc.
• Jonathan Charles, MD

• Physical Therapist in Brandon, FL
• Providers in Brandon, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.