Individual provider Active NPI

Rong Wang, M.D.

  • Internal Medicine Physician
  • Corvallis, OR
National Provider Identifier
1174574677
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD25068 Issued in OR
Practice address
3680 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone
(541) 754-1260
Fax
(541) 758-2680
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD25068 OR Primary

Addresses

Primary practice location

3680 NW Samaritan Dr
Corvallis, OR 97330-3737

Mailing address

444 NW Elks Dr
Corvallis, OR 97330-3745

Other identifiers 1

IdentifierTypeStateIssuer
233010MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20040623001310 OR Practitioner - Internal Medicine 7214912104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Corvallis Clinic P CGroup PAC ID 1456244540, 128 clinicians

Practice addresses (Care Compare)

2350 NW Century Dr
100 The Corvallis Clinic at Walnut Boulevar
Corvallis, OR 97330-3495
Phone (541) 754-1150

3680 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 754-1150

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD25068ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Corvallis Past Accepting new patients
Firstcare Medical Foundation Internal Medicine PastSince Sep 1, 2004 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rong.wang.1@14349.direct.athenahealth.com

Organizations & group practices 3

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 76

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

View all 76

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1174574677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 NW ELKS DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303737",
            "telephone_number": "541-754-1260",
            "fax_number": "541-758-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "RONG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD25068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233010",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.