MEDICARE: ANDREW YOUNG CHANG OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1800465A	IN
2	152W00000X	Optometrist	OPT.007490	OH

General Provider Information

NPI Number	:	1578495040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW YOUNG CHANG OD

Provider Business Mailing Address
First Line	:	3009 S XAVIER CT
Second Line	:
City	:	BLOOMINGTON
State	:	IN
Zip	:	47401-6883
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2090 FLORENCE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-2484
Country	:	US
Telephone Number	:	513-559-3599
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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