DR. SIMON CHANG (PT, DPT) – Physical Therapy Clinic/Center, NPI 1134936982

DR. SIMON CHANG (PT, DPT) is a healthcare provider. based in Loganville, Georgia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. PT016743 (GA). The NPI Number for DR. SIMON CHANG (PT, DPT) is 1134936982

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
DR. SIMON CHANG (PT, DPT)
NPI
1134936982
Phone
(770) 231-5842
Address
2887 MALTON WAY
Enumeration Date
16 December 2024
Last Update Date
16 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8665253175
Graduation Year
2023 (3 years ago)
PAC ID
3072042225
Group Practice PAC ID
4082027727
Professional Enrollment ID
I20250203000320
Address ID
GA303031292AT260XXNWXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

2,871 PHYSICAL THERAPIST IN PRIVATE PRACTICE in GA

Provider Addresses for DR. SIMON CHANG (PT, DPT)

  • 2887 MALTON WAY

    LOGANVILLE, GA 300521112

    Phone: (770) 231-5842

    Type: Mailing

  • 2456 SUMMEROAK DR

    TUCKER, GA 300843453

    Phone: (706) 810-0065

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-02-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250203000320IPhysical Therapist In Private PracticeGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30052)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082027727View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeLA
Physical Therapist In Private PracticeGA

Reviews

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Frequently asked questions

How is DR. SIMON CHANG (PT, DPT) identified in CMS data?
CMS-hosted NPPES data lists DR. SIMON CHANG (PT, DPT) with NPI 1134936982.
Can I rely on DR. SIMON CHANG (PT, DPT) being an active provider?
As of the registry snapshot, DR. SIMON CHANG (PT, DPT) is marked active.
What is DR. SIMON CHANG (PT, DPT)'s specialty?
The listing groups DR. SIMON CHANG (PT, DPT) with Physical Therapy Clinic/Center. Clinical services aligned with this taxonomy classification.
What area does DR. SIMON CHANG (PT, DPT) serve?
DR. SIMON CHANG (PT, DPT)'s listing highlights Loganville, Georgia; more addresses can appear in NPPES.
Why does DR. SIMON CHANG (PT, DPT) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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