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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SAMUEL YEJIN CHANG
NPI 1689446825
Physician Assistant in Vallejo, CA

Active since October 23, 2023PECOS Enrolled
1310 CLUB DR, VALLEJO, CA 94592(707) 638-5809 Get Directions Write a Review

NPPES record last updated: July 15, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 15, 2026, Oct 23, 2023 (2 updates tracked since 2023).

About Samuel Yejin Chang NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL YEJIN CHANG (NPI 1689446825) is an individual physician assistant in Vallejo, California, licensed in California (PA68670) and active in the NPI registry since October 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689446825
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameSAMUEL YEJIN CHANG
Location Address1310 CLUB DRVallejo, CA 94592-1187
Mailing Address1310 Club DrVallejo, CA 94592-1187 · (707) 638-5809
Phone(707) 638-5809
Sole ProprietorYes
Enumeration DateOctober 23, 2023
Last NPPES UpdateJuly 15, 20262 updates tracked since enumeration
NPPES CertifiedJuly 15, 2026
✔ NPI 1689446825 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · PA68670
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1310 CLUB DR, Vallejo, CA 94592
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Yejin Chang is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94592 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$98.85 typical visit price
range $65.02 – $191.95
Typical copayment $24.71 (range $16.25 – $47.98)
Most-billed visit code 99203
Established Patient
$80.24 typical visit price
range $21.86 – $157.69
Typical copayment $20.06 (range $5.46 – $39.42)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THAO-VY THI TRAN
Physician Assistant
1310 CLUB DR
VALLEJO, CA 94592
Solano County (707) 638-5200
CARLY COLE
Physician Assistant
1310 CLUB DR
VALLEJO, CA 94592
Solano County (707) 638-5809
RICARDO CALIXTRO-LOPEZ
Physician Assistant
1310 CLUB DR
VALLEJO, CA 94592
Solano County (707) 638-5809
ASHLEY NICOLE RITUALO CHAN
Physician Assistant
1310 CLUB DR
VALLEJO, CA 94592
Solano County (707) 638-5809
EMILY SPAIN
Physician Assistant
1310 CLUB DR
VALLEJO, CA 94592
Solano County (707) 638-5809
AUSTIN JOE WILLIS
Physician Assistant
1310 CLUB DR
VALLEJO, CA 94592
Solano County (707) 638-5809
ANNA NUNOO
Physician Assistant
1310 CLUB DR
VALLEJO, CA 94592
Solano County (707) 638-5809
MAYANKA BARATH
Physician Assistant
1310 CLUB DR
VALLEJO, CA 94592
Solano County (707) 638-5809

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Chang's NPI number?

The NPI number for Samuel Chang is 1689446825. It was assigned to this individual provider in the NPPES registry on October 23, 2023.

Where is Samuel Chang located?

Samuel Chang practices at 1310 Club Dr, Vallejo, CA 94592. The listed phone number is (707) 638-5809.

What is Samuel Chang's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Samuel Chang enrolled in Medicare?

Yes. Samuel Chang is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Samuel Chang was last updated on July 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 36 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.