Jacquelyn Wang

Primary specialty

OptometristTaxonomy code 152W00000X

License

1124 Issued in NV

Practice address

4175 S Grand Canyon Dr Ste 105
Las Vegas, NV 89147-7155

Phone

(702) 912-4254

Fax

(702) 847-7624

NPI assigned

Jun 24, 2015

Last updated

Jan 5, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, NV2 enrollments

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 2

Specialty

Optometry

Education

Southern California College of Optometry, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyediology Vision Care Burke PLLCGroup PAC ID 7719390566, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations (25 of 27)

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.

• Eyediology Vision Care Burke PLLC

  dba Eyediology Vision Care

  • Optometrist
  • Las Vegas, NV
  • NPI 1497341705
  Medicare reassignment Care Compare group NPD
• Shannon R. Chandler, Corp

  • Optometrist
  • Las Vegas, NV
  • NPI 1194890673
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Spectrum Eyecare Optometry Inc

  • Optometrist
  • San Dimas, CA
  • NPI 1801949573
  Medicare reassignment NPD
• Linden Optometry a Professional Corporation

  • Optometrist
  • Pasadena, CA
  • NPI 1831201078
  Medicare reassignment
• Pritchett Eye Care PC

  dba Pritchett Eye Care Associates (Carson)

  • Optometrist
  • Carson City, NV
  • NPI 1326351925
  NPD
• Pritchett Eye Care PC

  dba Pritchett Eye Care Associates (Sparks)

  • Optometrist
  • Sparks, NV
  • NPI 1679889372
  NPD
• Pritchett Eye Care PC

  dba ClearVision Eye Centers

  • Optometrist
  • Pahrump, NV
  • NPI 1730664327
  NPD
• Dpmotikonrca LLC

  • Podiatrist
  • Bishop, CA
  • NPI 1285952150
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Visionworks, Inc

  dba Visionworks

  • Eyewear Supplier
  • Simpsonville, SC
  • NPI 1699571166
  NPD (past)

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1215319496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 S GRAND CANYON DR STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891477155",
            "telephone_number": "702-912-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 S GRAND CANYON DR STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891477155",
            "telephone_number": "702-912-4254",
            "fax_number": "702-847-7624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3285 Claremont Way",
            "address_purpose": "LOCATION",
            "city": "Napa",
            "state": "CA",
            "postal_code": "945583313",
            "country_code": "US",
            "telephone_number": "707-258-2076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "JACQUELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15226TLG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "1124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215319496",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3285 Claremont Way",
            "city": "Napa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945583313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Henry Wang, M.D.
• Hewei Wang
• Hong Wang
• Hsiao K Wang
• Hui Lian Wang
• Jason S Wang, OD
• Jeffrey Wang, DMD
• Jian Wang
• Jihsteve Wang
• Jimmy Chihhong Wang, M.D.

• Optometrist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.