MAI LEE CHANG (PA-C) – Medical Physician Assistant, NPI 1114479003

MAI LEE CHANG (PA-C) is a healthcare provider. based in Saint paul, Minnesota. specializing in Medical Physician Assistant. They hold the professional credentials PA-C. They hold a License No. 12128 (MN). The NPI Number for MAI LEE CHANG (PA-C) is 1114479003

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
MAI LEE CHANG (PA-C)
NPI
1114479003
Phone
(651) 558-2191
Address
1544 TIMBERLAKE RD
Enumeration Date
26 October 2016
Last Update Date
26 October 2016

Doctor Profile

Medical School Name
UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Secondary Phone
6516027500
Graduation Year
2010 (16 years ago)
PAC ID
0345580627
Group Practice PAC ID
2062306434
Professional Enrollment ID
I20190325000101
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

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Provider Addresses for MAI LEE CHANG (PA-C)

  • 1544, Timberlake Road, John J. McDonough Homes, Saint Paul, Ramsey County, Minnesota, 55117, United States

    SAINT PAUL, MN 551173946

    Phone: (651) 558-2191

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $19.

Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.

Last reported payment date: 2023-03-02 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($19).

Total Amount

$19

General + Research + Ownership

Payments

1

Total payment records

General Amount

$19

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-02

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2019-03-25

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
I20190325000101IPhysician AssistantMNTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
36415Insertion of needle into vein for collection of blood sample7446$0
83036Hemoglobin a1c level4127$0
82043Urine microalbumin (protein) level1715$0
90471Administration of vaccine1111$0
View full utilization report →

Insurance plans in this area (ZIP 55117)

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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: 2062306434View full group profile
NameSpecialtyState
Physician AssistantMN
Certified Nurse Midwife (Cnm)MN
Mental Health CounselorMN
Certified Nurse Midwife (Cnm)MN
Certified Nurse Midwife (Cnm)MN
Physician AssistantMN
-NJ
Family PracticeMN
Clinical Social WorkerFL
Nurse PractitionerMN

Reviews

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Frequently asked questions

How do I look up MAI LEE CHANG (PA-C) by NPI?
Use NPI 1114479003 when you need to reference MAI LEE CHANG (PA-C) in forms, claims, or directories.
Is MAI LEE CHANG (PA-C) currently active in the NPI registry?
CMS-published data lists MAI LEE CHANG (PA-C) as an active registrant.
Can you summarize MAI LEE CHANG (PA-C)'s specialty in plain language?
Clinically, the directory lists MAI LEE CHANG (PA-C) with Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Does MAI LEE CHANG (PA-C) practice in Minnesota?
You will see Saint Paul, Minnesota on file for MAI LEE CHANG (PA-C) alongside any extra practice locations.
Is MAI LEE CHANG (PA-C) a real provider?
This page reflects official NPPES data for NPI 1114479003. Always confirm identity and privileges with the practice and licensing boards.

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