Individual provider Active NPI

Rui Wang, MD

  • Ophthalmology Physician
  • Hixson, TN
National Provider Identifier
1154958171
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
75789 Issued in TN
Practice address
1961 Northpoint Blvd Ste 110
Hixson, TN 37343-4556
Phone
(423) 756-1002
NPI assigned
Mar 27, 2020
Last updated
Jul 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 75789 TN Primary
Retina Specialist (Ophthalmology) Physician 207WX0107X 75789 TN
Retina Specialist (Ophthalmology) Physician 207WX0107X 2024007822 MO

Addresses

Primary practice location

1961 Northpoint Blvd Ste 110
Hixson, TN 37343-4556

Mailing address

9050 Executive Park Dr Ste 202a
Knoxville, TN 37923-4670
Phone (865) 588-0811

Other practice location 1

1600 S Brentwood Blvd Ste 700
Brentwood, MO 63144-1304
Phone (314) 367-1181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL, TN, GA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20240515000637 MO Practitioner - Ophthalmology 6002238722 Reassigns benefits to 1 organization
I20240624000911 IL Practitioner - Ophthalmology 6002238722 Reassigns benefits to 1 organization
I20260512002493 TN Practitioner - Ophthalmology 6002238722 Reassigns benefits to 1 organization
I20260512004634 GA Practitioner - Ophthalmology 6002238722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Texas a & M University System, HSC, College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retina Consultants LLCGroup PAC ID 9537259957, 16 clinicians

Practice addresses (Care Compare)

1009 42ND St
Suite 3
Mt Vernon, IL 62864-6218
Phone (314) 367-1181

12106 Tesson Ferry Rd
Saint Louis, MO 63128-1729
Phone (314) 367-1181

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.24 of 100Reported as group
Quality
95.45
Promoting interoperability
72
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Retina Associates, P.C. Single Specialty CurrentSince Mar 24, 2026 Accepting new patients
River Rock Behavioral Health, LLC Single Specialty CurrentSince Sep 8, 2024 Accepting new patients
Retina Consultants, LLC Single Specialty CurrentSince Jul 1, 2024 Accepting new patients
Hermann Area Hospital District Single Specialty PastSince Jun 1, 2024 Accepting new patients
The Retina Institute LLC Single Specialty PastSince Jul 1, 2024 Accepting new patients
Southeastern Retina Associates, P.C. Single Specialty PastSince Mar 24, 2026 Accepting new patients

Locations

1506 N Thornton Ave
Ste D
Dalton, GA 30720
Phone (706) 229-5980

210 Redmond Rd NW
Rome, GA 30165
Phone (706) 234-8221

903 Medical Park Dr
Effingham, IL 62401
Phone (217) 347-2933

5 Country Club Executive Park
Glen Carbon, IL 62034
Phone (314) 567-7771

5 Country Club Executive Park
#P
Glen Carbon, IL 62034
Phone (800) 888-0011

1009 S 42nd St
Ste 3
Mount Vernon, IL 62864
Phone (618) 244-6161

1125 Hampshire St
Quincy, IL 62301
Phone (217) 222-3937

1600 S Brentwood Blvd
Ste 700
Brentwood, MO 63144

226 S Woods Mill Rd
Ste 50W
Chesterfield, MO 63017

17 The Boulevard Saint Louis
Saint Louis, MO 63117

2201 S Brentwood Blvd
Saint Louis, MO 63144
Phone 31436711812267

8820 Ladue Rd
Ste 203
Saint Louis, MO 63124
Phone 31436711812267

5770 Mexico Rd
Ste D
Saint Peters, MO 63376
Phone (314) 842-2020

232 S Woods Mill Rd
Town and Country, MO 63017
Phone (314) 205-6030

1606 Gunbarrel Rd
Ste 1
Chattanooga, TN 37421

1961 Northpoint Blvd
Ste 110
Hixson, TN 37343

9050 Executive Park Dr
Ste 202A
Knoxville, TN 37923

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/f62890b5-77ff-44bd-a981-0a0981047b35/
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: rwang@rcstl.intellechartdirect.net

Organizations & group practices 6

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 1

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": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1154958171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9050 EXECUTIVE PARK DR STE 202A",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234670",
            "telephone_number": "865-588-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1961 NORTHPOINT BLVD STE 110",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434556",
            "telephone_number": "423-756-1002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 S Brentwood Blvd Ste 700",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "MO",
            "postal_code": "631441304",
            "country_code": "US",
            "telephone_number": "314-367-1181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "RUI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "75789",
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TN",
            "license": "75789",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MO",
            "license": "2024007822",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

Verify at the official NPI Registry.