Heidi Soo-Jin Chang, PA-C
Physician Assistant in New York, NY. Individual provider (NPI-1).
NPI number1649744707
StatusActive
Last updated in NPPESMar 29, 2019
Details
- NPI
- 1649744707
- Entity type
- Individual (NPI-1)
- Name
- Heidi Soo-Jin Chang
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 11, 2019
- Last updated
- Mar 29, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 023145 | NY | Yes |
Practice location
160 Broadway Fl 16New York, NY 10038
Phone 516-505-7200
Mailing address
160 Broadway Fl 16New York, NY 10038-4207
Phone 516-505-7200
Other practice locations
430 E 77th St Apt 4b
New York, NY 10075-2382
New York, NY 10075-2382
Phone 917-293-8992
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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