NPIMap

Individual provider Active NPI

Edwin Yen Wang, MD

  • Diagnostic Radiology Physician
  • Salem, OR
National Provider Identifier
1093779282
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
27734 Issued in OR
Practice address
698 12TH St SE Ste 145
Salem, OR 97301
Phone
(503) 588-2674
Fax
(503) 391-1200
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 27734 OR Primary

Addresses

Primary practice location

698 12TH St SE Ste 145
Salem, OR 97301

Mailing address

698 12TH St SE Ste 145
Salem, OR 97301-4076
Phone (503) 588-2674

Other identifiers 1

IdentifierTypeStateIssuer
241589MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070917000562 OR Practitioner - Diagnostic Radiology 5890690580 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Michigan Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tualatin Imaging PCGroup PAC ID 8123011392, 18 clinicians
Willamette Radiology Billing Services LLCGroup PAC ID 9335681972, 15 clinicians
Good Shepherd Health Care SystemGroup PAC ID 9133033764, 125 clinicians
Grande Ronde Hospital IncGroup PAC ID 0547170789, 97 clinicians

Practice addresses (Care Compare)

19300 SW 65TH Ave
Tualatin, OR 97062-7706
Phone (503) 692-7447

2700 SE Stratus Ave
McMinnville, OR 97128-6255
Phone (503) 435-6322

610 NW 11TH St
Hermiston, OR 97838-6601
Phone (541) 667-3400

900 Sunset Dr
La Grande, OR 97850-1387
Phone (541) 963-8421

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
77.82 of 100Reported as group
Quality
64.68
Promoting interoperability
100
Improvement activities
40
Cost
47.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27734ORMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Healthcare Services Inc CurrentSince Apr 20, 2024 Accepting new patients
Grande Ronde Hospital, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Grande Ronde Hospital, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Tualatin Imaging P C Diagnostic Radiology CurrentSince Feb 1, 2020 Accepting new patients
Willamette Radiology Billing Services LLC Diagnostic Radiology CurrentSince Mar 26, 2024 Accepting new patients
Good Shepherd Health Care System CurrentSince Mar 1, 2020 Accepting new patients
Larsen Sanchez Psychology, LLC Past Accepting new patients
New York University Medical Center Faculty Practice Radiology Diagnostic Radiology Past Accepting new patients
Nyumc Radiology Associates Diagnostic Radiology Past Accepting new patients

Locations

610 NW 11th St
Hermiston, OR 97838
Phone (541) 667-3400

900 Sunset Dr
La Grande, OR 97850
Phone (541) 963-8421

2700 SE Stratus Ave
McMinnville, OR 97128
Phone (503) 435-1200

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

Organizations & group practices 9

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

Hospital & facility affiliations 8

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1093779282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "698 12TH ST SE STE 145",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014076",
            "telephone_number": "503-588-2674",
            "fax_number": "503-391-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "698 12TH ST SE STE 145",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97301",
            "telephone_number": "503-588-2674",
            "fax_number": "503-391-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "EDWIN",
        "middle_name": "YEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "27734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241589",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.