Individual provider Active NPI

Xiao-Tian Austin, MD

  • Diagnostic Radiology Physician
  • Normal, IL
National Provider Identifier
1174583744
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036.123730 Issued in IL
Practice address
1300 Franklin Ave
Normal, IL 61761-3592
Phone
(309) 454-1400
NPI assigned
Mar 27, 2006
Last updated
Feb 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X PENDING RI
Diagnostic Radiology Physician 2085R0202X 036.123730 IL Primary

Addresses

Primary practice location

1300 Franklin Ave
Normal, IL 61761-3592

Mailing address

611 W Park St
Fapc
Urbana, IL 61801-2500

Other practice location 1

2200 Fort Jesse Rd
Ste. 280
Normal, IL 61761-6286
Phone (309) 452-1788

Other identifiers 2

IdentifierTypeStateIssuer
036123730MedicaidIL
036.123730OtherILSTATE LICENSE

Other names 1

  • Xiao-Tian Wang Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20090831000249 IL Practitioner - Diagnostic Radiology 6800809732 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Icahn School of Medicine at Mount Sinai, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians

Practice addresses (Care Compare)

101 S Major St
Eureka, IL 61530-1246
Phone (309) 304-2128

2204 Eastland Dr
Bloomington, IL 61704-3567
Phone (309) 663-0222

3024 E Empire St
Bloomington, IL 61704-5402

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.123730ILMDDiagnostic Radiology Physician
PENDINGRIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Feb 18, 2016 Accepting new patients
Carle Health Medical Group CurrentSince May 8, 2023 Accepting new patients
Carle West Physician Group Inc CurrentSince May 8, 2023 Accepting new patients
Richland Memorial Hospital, Inc Current Accepting new patients
Jackson Park Hospital Foundation Current Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Aug 28, 2023 Accepting new patients
Richland Memorial Hospital, Inc. CurrentSince Aug 28, 2023 Accepting new patients
X-Ray Associates, Inc Diagnostic Radiology Past Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1300 Franklin Ave
Normal, IL 61761
Phone (309) 268-2560

2200 Fort Jesse Rd
Ste 280
Normal, IL 61761
Phone (800) 755-9195

800 E Locust St
Olney, IL 62450
Phone (618) 395-2131

900 E Scott St
Olney, IL 62450
Phone (618) 345-1000

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

2300 N Rockton Ave
Rockford, IL 61103

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: xiao-tianaustin@jph.medalliesdirect.net

Organizations & group practices 8

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 2

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1174583744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 FRANKLIN AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613592",
            "telephone_number": "309-454-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Fort Jesse Rd",
            "address_2": "Ste. 280",
            "address_purpose": "LOCATION",
            "city": "Normal",
            "state": "IL",
            "postal_code": "617616286",
            "country_code": "US",
            "telephone_number": "309-452-1788",
            "fax_number": "309-862-1302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AUSTIN",
        "first_name": "XIAO-TIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036.123730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036123730",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036.123730",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "XIAO-TIAN",
            "last_name": "WANG",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Normal, IL

Sources for this page

Verify at the official NPI Registry.