Individual provider Active NPI

Oliver Wang, D.P.M.

  • Podiatrist
  • Burbank, CA
National Provider Identifier
1063516409
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E4275 Issued in CA
Practice address
241 W Olive Ave
Burbank, CA 91502-1825
Phone
(818) 848-5583
Fax
(818) 848-1872
NPI assigned
Sep 7, 2006
Last updated
Apr 6, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4275 CA
Podiatrist 213E00000X E4275 CA Primary

Addresses

Primary practice location

241 W Olive Ave
Burbank, CA 91502-1825

Mailing address

268 N Mar Vista Ave Apt 4
Pasadena, CA 91106-5314
Phone (818) 848-5583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101026000512 CA Practitioner - Podiatry 9537187950 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot and Ankle Concepts IncGroup PAC ID 5395770085, 10 clinicians

Practice addresses (Care Compare)

302 N Milpas St
Santa Barbara, CA 93103-3204
Phone (805) 845-1245

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue158
Removal of skin lesions39
Removal of nail tissue1106
Removal or shaving of skin growth980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4275CAMDFoot & Ankle Surgery Podiatrist
4275CAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare California, PC Podiatrist CurrentSince Nov 1, 2021 Accepting new patients
Upperline Healthcare California PC Foot & Ankle Surgery CurrentSince Nov 1, 2021 Accepting new patients
Foot & Ankle Concepts, Inc Podiatrist CurrentSince Jul 1, 2024 Accepting new patients
Burbank Podiatry Asscociates Group a Professional Corporation Podiatrist CurrentSince Mar 1, 2009 Accepting new patients

Locations

241 W Olive Ave
Burbank, CA 91502
Phone (818) 848-5561

3901 Las Posas Rd
Ste 204
Camarillo, CA 93010
Phone (805) 383-2929

16465 Sierra Lakes Pkwy
Ste 240
Fontana, CA 92336
Phone (909) 355-3100

5565 Grossmont Center Dr
Ste 510
La Mesa, CA 91942
Phone (619) 303-7130

2131 San Joaquin Hills Rd
Newport Beach, CA 92660
Phone (949) 326-7355

9017 Reseda Blvd
Ste 100
Northridge, CA 91324
Phone (818) 885-8400

2100 Solar Dr
Ste 102
Oxnard, CA 93036
Phone (805) 650-8333

650 Commerce Ave
Ste D
Palmdale, CA 93551
Phone (661) 272-6898

3600 Central Ave
Ste 4
Riverside, CA 92506
Phone (951) 355-2956

302 N Milpas St
Santa Barbara, CA 93103
Phone (805) 845-1245

3180 Willow Ln
Ste 108
Thousand Oaks, CA 91361
Phone (805) 370-3338

250 S Mills Rd
Ste 101
Ventura, CA 93003
Phone (805) 650-8333

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: oliver.wang.1@4399.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302048000000",
    "number": "1063516409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 N MAR VISTA AVE APT 4",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911065314",
            "telephone_number": "818-848-5583",
            "fax_number": "818-848-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 W OLIVE AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021825",
            "telephone_number": "818-848-5583",
            "fax_number": "818-848-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "OLIVER",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2011-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4275",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.