Individual provider Active NPI

Nan Wang, M. D.

  • Ophthalmology Physician
  • Houston, TX
National Provider Identifier
1104807759
Registry record updated May 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
K3035 Issued in TX
Practice address
4645 Southwest Fwy Ste 100
Houston, TX 77027-7163
Phone
(713) 467-3393
Fax
(832) 467-3393
NPI assigned
Nov 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X K3035 TX Primary

Addresses

Primary practice location

4645 Southwest Fwy Ste 100
Houston, TX 77027-7163

Mailing address

4645 Southwest Fwy Ste 100
Houston, TX 77027-7163
Phone (713) 467-3393

Other identifiers 1

IdentifierTypeStateIssuer
141970704MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101203000440 TX Practitioner - Ophthalmology 3577657311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Baylor College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4645 Southwest Fwy
Suite 100
Houston, TX 77027-7163
Phone (713) 467-3393

Merit-based Incentive Payment System (MIPS)

Final score
95.43 of 100Reported as individual
Quality
91.7
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery140

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K3035TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Eye Center, PLLC Ophthalmology CurrentSince Dec 1, 2019 Accepting new patients

Locations

4645 Southwest Fwy
Ste 100
Houston, TX 77027
Phone (713) 467-3393

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1104807759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 SOUTHWEST FWY STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770277163",
            "telephone_number": "713-467-3393",
            "fax_number": "832-467-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 SOUTHWEST FWY STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770277163",
            "telephone_number": "713-467-3393",
            "fax_number": "832-467-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "NAN",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "K3035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141970704",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.