Dr Jeannie Won Chang, PSYD is a medicare enrolled "Psychologist" provider in San Francisco, California. Her current practice location is
555 Polk St, San Francisco, California. You can reach out to her office (for appointments etc.) via phone at
(415) 292-2565.
Dr Jeannie Won Chang is licensed to practice in California (license number PSY27785) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1104055029.
Healthcare Provider's Profile
| Full Name | Dr Jeannie Won Chang |
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| Gender | Female |
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| Speciality | Psychologist |
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| Location | 555 Polk St, San Francisco, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1104055029
- Provider Enumeration Date: 07/13/2009
- Last Update Date: 03/26/2019
Medicare PECOS Information:
- PECOS PAC ID: 2466821608
- Enrollment ID: I20221212000842
Medical Identifiers
Medical identifiers for Dr Jeannie Won Chang such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104055029 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | PSY27785 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jeannie Won Chang allows following entities to bill medicare on her behalf.
| Entity Name | Norbert B Ralph |
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| Entity Type | Practitioner - Clinical Psychologist |
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| Entity Identifiers | NPI Number: 1083672877
PECOS PAC ID: 6204993777
Enrollment ID: I20090327000175 |
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| Entity Name | Jeannie Chang Psychologist Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124899877
PECOS PAC ID: 1759726730
Enrollment ID: O20240229001441 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jeannie Won Chang is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Jeannie Won Chang, PSYD
555 Polk St,
San Francisco, CA 94102-3333
Ph: (415) 292-2565 | Dr Jeannie Won Chang, PSYD
555 Polk St,
San Francisco, CA 94102-3333
Ph: (415) 292-2565 |
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