Individual provider Active NPI

Wing Man Yip, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1114373560
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3539 Issued in MN
Practice address
3241 S Michigan Ave
Chicago, IL 60616-4201
Phone
(312) 949-7751
NPI assigned
May 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010997 IL
Optometrist 152W00000X 3539 MN Primary

Addresses

Primary practice location

3241 S Michigan Ave
Chicago, IL 60616-4201

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

1544 Greenview Dr SW
Rochester, MN 55902-4322
Phone (507) 287-2711

Other practice location 2

3241 S Michigan Ave
Chicago, IL 60616-4201
Phone (312) 949-7751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20180608001118 MN Practitioner - Optometry 3779873690 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester Family Eye Clinic LLCGroup PAC ID 7214952662, 6 clinicians

Practice addresses (Care Compare)

3630 11TH Ave NW
Rochester, MN 55901-4276
Phone (507) 288-2457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3539MNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Spectacle Shoppe Inc. Optometrist Current Accepting new patients
Rochester Family Eye Clinic LLC Optometrist CurrentSince Oct 1, 2024 Accepting new patients
The Spectacle Shoppe Inc Optometrist CurrentSince May 7, 2018 Accepting new patients
Spectacle Shoppe Inc. Optometrist CurrentSince May 7, 2018 Accepting new patients
Gundersen Clinic LTD Past Accepting new patients

Locations

3630 11th Ave NW
Rochester, MN 55901
Phone (507) 288-2457

1089 Grand Ave
Saint Paul, MN 55105
Phone (651) 797-4834

2050 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 636-3434

Organizations & group practices 5

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": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1114373560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3241 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164201",
            "telephone_number": "312-949-7751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1544 Greenview Dr SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559024322",
            "country_code": "US",
            "telephone_number": "507-287-2711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3241 S Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606164201",
            "country_code": "US",
            "telephone_number": "312-949-7751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YIP",
        "first_name": "WING MAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010997",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.