TAE YONG CHANG – Allergy Physician, NPI 1467959619
Allergy Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
91 ALLERGY/IMMUNOLOGY in MN
Provider Addresses for TAE YONG CHANG
565 SNELLING AVE S
SAINT PAUL, MN 551161525
Phone: (651) 698-0386
Type: Mailing
Banner University Medical Center Phoenix, 1111, East McDowell Road, Phoenix, Maricopa County, Arizona, 85006, United States
PHOENIX, AZ 850062612
Phone: (602) 839-2266
Type: Location
1231, Whistler Hollow Drive, Colorado Springs, El Paso County, Colorado, 80906, United States
COLORADO SPRINGS, CO 809066550
Phone: (719) 761-8082
Type: Mailing
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: 2025-01-06
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250106000609 | I | Allergy/Immunology | MN | TBD |
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.
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 55116)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine, Allergy/Immunology | MN | |
| - | MN | |
| Allergy/Immunology, Pediatric Medicine | MN | |
| Allergy/Immunology, Pediatric Medicine | LA |
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