THEODORE T CHANG (NPI# 1477503936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477503936 |
| Entity Type | Individual |
| Full Name | THEODORE T CHANG |
| Credential | M.D. |
| Practice Address |
319 S Manning Blvd Suite 106 Albany NY 12208-1742 |
| Practice Telephone | 5184381019 |
| Practice Fax Number | 5184380981 |
| Mailing Telephone | 5184381019 |
| Mailing Fax Number | 5184380981 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 204809-1 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | BLUE SHIELD NORTHEASTERN | 00406922007 | 01 |
| NY | RAILROAD MEDICARE | P00291584 | 01 |
| NY | GHI HMO | 92950 | 01 |
| NY | CAPITAL DISTRICT PHYSICIA | 10002480 | 01 |
| NY | GHI PPO | 1099057 | 01 |
| NY | MOHAWK VALLEY PHYSICIANS | 24134 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871832774 | Theodore K Chang | Dentist | 749 Bloomfield Ave Ste D, West Caldwell, NJ 07006 | 2013-02-12 |
| 1093101420 | Theodore Chang | Student in an Organized Health Care Education/Training Program | 1356 Lusitana St, Ste. 510, Honolulu, HI 96813-2409 | 2015-04-13 |
| 1154617843 | Theodore Chang | Pathology | 4850 Northshore Ln, North Little Rock, AR 72118 | 2011-06-22 |
| Street Address |
319 S MANNING BLVD SUITE 106 |
| City | ALBANY |
| State | NY |
| Zip Code | 12208-1742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609877422 | Thomas E Canavan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 319 S Manning Blvd, Suite 110, Albany, NY 12208-1742 | 2005-08-02 |
| 1639702772 | Mark Thomas Grunert | Physician Assistant | 319 S Manning Blvd, Albany, NY 12208-1742 | 2020-02-18 |
| 1023479474 | Kimberley Lamora | Dietitian, Registered | 319 S Manning Blvd, Albany, NY 12208-1742 | 2016-03-14 |
| 1063885788 | St. Peter's Hospital | Internal Medicine | 319 S Manning Blvd, Suite 110b, Albany, NY 12208-1742 | 2015-11-03 |
| 1245628361 | St. Peters Health Partners Medical Associates PC | Surgery | 319 S Manning Blvd, Suite 304, Albany, NY 12208-1742 | 2014-12-23 |
| 1730595539 | Maureen Patricia Mccoll | Pharmacist | 319 S Manning Blvd, Department of Pharmacy, Albany, NY 12208-1742 | 2014-07-01 |
| 1104164474 | Joseph M Bied M D LLC | Obstetrics & Gynecology | 319 S Manning Blvd, Suite 306, Albany, NY 12208-1773 | 2013-01-22 |
| 1689911869 | Jenna K Horton | Nurse Practitioner | 319 S Manning Blvd, Albany, NY 12208-1742 | 2013-01-09 |
| 1891047247 | Michael Perrotti Md PC | Urology | 319 S Manning Blvd, Suite 308a, Albany, NY 12208-1742 | 2012-10-10 |
| 1285999649 | Elizabeth M Wyman | Dietitian, Registered | 319 S Manning Blvd, Suite 307, Albany, NY 12208 | 2012-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255959045 | Fatima Mahmood | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Department of Internal Medicine, Albany, NY 12208 | 2020-07-08 |
| 1861021784 | Jessica Anne Charles-larose | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Family Medicine, Albany, NY 12208 | 2020-04-02 |
| 1235767211 | Michael Charles Harrington | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Orthopedic Surgery, Albany, NY 12208 | 2020-03-27 |
| 1518594126 | Arkar Htoo | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of Pathology, Albany, NY 12208 | 2020-03-24 |
| 1366079030 | Omar Merdan | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Dept of Medicine/pediatrics, Albany, NY 12208 | 2020-03-24 |
| 1306473079 | Sergo Gabunia | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of General Surgery, Albany, NY 12208 | 2020-03-24 |
| 1205469392 | Cornell Andre Morris | Social Worker | Albany Stratton Va Medical Center, 113 Holland Avenue, Albany, NY 12208 | 2020-02-17 |
| 1558909234 | St. Peter's Health Partners Medical Associates, P.C. | Surgery | 319 South Manning Blvd Suite 310, Capital Region Colon & Rectal Surgery, Albany, NY 12208 | 2019-12-13 |
| 1912543265 | Meghan Rose Baxter | Social Worker | 58 Academy Rd., Albany, NY 12208 | 2019-11-21 |
| 1245883461 | Gwendolyn Medak | Registered Nurse | 15 New Scotland Ave, Albany, NY 12208 | 2019-07-17 |
| Find all providers in zip 12208 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235525916 | William Kelvin Lane | Urology | 2009 Palmyra Rd, Albany, GA 31701-1576 | 2015-04-09 |
| 1962586776 | Mark White | Urology | The Urological Institute of Northeastern New York, South Clinical Campus, 23 Hackett Blvd., Albany, NY 12208 | 2006-10-25 |
| 1225118284 | Hugh Fisher | Urology | South Clinical Campus, 23 Hackett Blvd. (mc 208), Albany, NY 12208 | 2006-10-16 |
| 1174625693 | Keith A Schulze | Urology | 400 Hickory St Nw Ste 200, Albany, OR 97321-1700 | 2006-09-04 |
| 1497790430 | Martin S Engelstein | Urology | 4 Executive Park, Albany, NY 12203-3718 | 2006-06-16 |
| 1912967241 | Donald Joseph Rivard | Urology | 25 Hackett Blvd, Division of Urology (mc 208), Albany, NY 12208-3420 | 2006-03-23 |
| 1811964430 | Barry A Shuman | Urology | 63 Shaker Rd Suite 202, Albany Memorial Professional Bldg, Albany, NY 12204-1030 | 2006-03-02 |
| 1932175924 | Sophia Drinis | Urology | 400 Hickory St Nw, Suite 200, Albany, OR 97321-1700 | 2006-02-28 |
| 1811983711 | Carl Robert Hall | Urology | 920 8th Ave Sw, Albany, OR 97321-2407 | 2005-09-26 |
| 1467447938 | Michael D. Daugherty | Urology | 2400 Osler Ct, Albany, GA 31707 | 2005-09-12 |
| Find all providers in ALBANY | ||||
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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.