DR. JASON L CHANG (NPI# 1174739072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174739072 |
| Entity Type | Individual |
| Full Name | DR. JASON L CHANG |
| Credential | M.D. |
| Practice Address |
55 Meriden Ave Ste 1a Southington CT 06489-3237 |
| Practice Telephone | 8606219316 |
| Mailing Telephone | 8606219316 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2012-08-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
049717 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TAXPAYER IDENTIFICATION | 204892866 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457252 | Jason Chang | Behavior Technician | 3 Boothby Cir, Randolph, MA 02368-5312 | 2020-11-06 |
| 1194986711 | Jason Wayne Chang | Dentist | 701 Shedeck Pkwy, Yukon, OK 73099-6021 | 2008-06-17 |
| 1144313297 | Jason H Chang | Dentist | 1101 Avenue D, C104, Snohomish, WA 98290-2083 | 2006-10-02 |
| 1457811853 | Jason Yu-shen Chang | Student in an Organized Health Care Education/Training Program | 24 Hospital Ave, Danbury, CT 06810-6099 | 2019-03-21 |
| 1326507641 | Jason Lin Chang | Student in an Organized Health Care Education/Training Program | 4733 W Sunset Blvd Fl 3, Los Angeles, CA 90027-6021 | 2019-03-16 |
| 1780190066 | Jason Chang | Nurse Practitioner | 1660 S Columbian Way, Seattle, WA 98108-1532 | 2017-12-21 |
| 1578822441 | Jason Chang | Student in an Organized Health Care Education/Training Program | 4733 W Sunset Blvd Fl 3, Los Angeles, CA 90027-6021 | 2012-05-11 |
| 1538472196 | Jason C Chang | Pathology | 1275 York Ave Dept Of, New York, NY 10065 | 2010-07-23 |
| 1124284708 | Jason Victor Chang | Psychiatry & Neurology | 1701 E Woodfield Road, Suite 1000, Schaumburg, IL 60173-5113 | 2008-08-02 |
| 1215198056 | Jason Jinwoo Chang | Psychiatry & Neurology | 110 Irving St Nw, Suite 4b42, Washington, DC 20010-3017 | 2008-06-24 |
| Street Address |
55 MERIDEN AVE STE 1A |
| City | SOUTHINGTON |
| State | CT |
| Zip Code | 06489-3237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720136757 | Wylie David Hosmer | Internal Medicine | 55 Meriden Ave Ste 1a, Southington, CT 06489-3237 | 2007-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467087783 | Shankar Panwar | Counselor | K 11, 1783 Meriden Waterbury Tpke, Southington, CT 06489 | 2020-03-06 |
| 1235771056 | Kathleen Rebecca Mckinney | Music Therapist | 196 Queen St., Southington, CT 06489 | 2019-10-14 |
| 1336700103 | Julie Amanda Nichols | Behavioral Analyst | 1842 Meriden-waterbury Turnpike, Southington, CT 06489 | 2019-06-24 |
| 1396238960 | Kriston Ronalter | Physician Assistant | 775 Queen Street, Southington, CT 06489 | 2018-06-08 |
| 1366933582 | Cj's Counseling, LLC | Counselor | 17 Meriden Ave Ste 1a, Southington, CT 06489 | 2018-05-23 |
| 1104329887 | Koby Douglas Fowler | Chiropractor | 1095 West St Unit 1, Southington, CT 06489 | 2018-03-09 |
| 1447763131 | Samreen, LLC | Clinic/Center | 775 Queen St, Suite 2, Southington, CT 06489 | 2017-11-16 |
| 1902320724 | Michael Petit | Physical Therapist | 98 Main Street, 202, Southington, CT 06489 | 2017-08-02 |
| 1457712127 | Leslie Mclaughlin | Speech-Language Pathologist | 400 Flanders Rd, Southington, CT 06489 | 2016-03-09 |
| 1306219159 | Breanne Schnepf-hanbury | Counselor | 26 N Main St Ste 2b, Southington, CT 06489 | 2015-11-02 |
| Find all providers in zip 06489 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720136757 | Wylie David Hosmer | Internal Medicine | 55 Meriden Ave Ste 1a, Southington, CT 06489-3237 | 2007-01-08 |
| 1710979463 | Peter David Byeff | Internal Medicine | 55 Meriden Ave, Ste 1a, Southington, CT 06489-3238 | 2005-08-18 |
| 1588618185 | Cancer Center of Central Connecticut LLC | Internal Medicine | 55 Meriden Ave, Southington, CT 06489-3237 | 2006-05-19 |
| 1508844010 | Brian J Byrne | Internal Medicine | 55 Meriden Ave, Suite 1-a, Southington, CT 06489-3238 | 2006-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154751907 | David S Fischer | Internal Medicine | 17 Abigail St, Milford, CT 06460-7918 | 2013-11-14 |
| 1265746879 | Eric Bleickardt | Internal Medicine | 3 Hidden Brook Rd, Hamden, CT 06518-1764 | 2010-08-06 |
| 1467763946 | Kelsey Thompson Martin | Internal Medicine | 240 Indian River Rd Ste A1, Orange, CT 06477-3690 | 2010-06-29 |
| 1780907295 | Kenneth L Sacks | Internal Medicine | 10 Oyster Landing Rd, Milford, CT 06460-6566 | 2010-03-11 |
| 1396981668 | Michael W Rosen | Internal Medicine | 32 Mackay Farm Rd, Woodbury, CT 06798-2509 | 2008-12-17 |
| 1083879134 | Jia Li | Internal Medicine | 950 Campbell Ave # 111d, West Haven, CT 06516-2770 | 2008-07-28 |
| 1760643407 | Sudhanshu Bharat Mulay | Internal Medicine | 114 Woodland Street / Cancer Center, Saint Francis Medical Group, Inc, Hartford, CT 06105-0000 | 2008-06-24 |
| 1194938324 | Anamika Katoch | Internal Medicine | 1075 Chase Pkwy Ste B, Harold Leever Cancer Center, Waterbury, CT 06708-2948 | 2007-05-07 |
| 1760694327 | Joseph Donadio | Internal Medicine | 140 Blue Hills Rd, Durham, CT 06422-3100 | 2007-05-04 |
| 1144303892 | Medical Specialists of Fairfield, LLC | Internal Medicine | 4699 Main Street, Fairfield, CT 06824 | 2006-10-23 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHINGTON |
| Zip Code | 06489 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.