Individual provider Active NPI

Weixun Wang, OD

  • Optometrist
  • Fishkill, NY
National Provider Identifier
1265920920
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV008764 Issued in NY
Practice address
969 Main St Ste H
Fishkill, NY 12524-1791
Phone
(845) 896-6700
Fax
(845) 896-6882
NPI assigned
Apr 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV008764 NY Primary

Addresses

Primary practice location

969 Main St Ste H
Fishkill, NY 12524-1791

Mailing address

969 Main St Ste H
Fishkill, NY 12524-1791
Phone (845) 896-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20180719002479 NY Practitioner - Optometry 0143577296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Dutchess Eyecare, LLPGroup PAC ID 7416846480, 4 clinicians

Practice addresses (Care Compare)

969 Main St
Suite H
Fishkill, NY 12524-1791
Phone (845) 896-6700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV008764NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Dutchess Eyecare, LLP Optometrist CurrentSince Oct 14, 2019 Accepting new patients
Lederman and Lederman LLP PastSince Jul 28, 2019 Accepting new patients

Locations

969 Main St
Ste H
Fishkill, NY 12524
Phone (845) 896-6700

Organizations & group practices 2

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": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1265920920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 MAIN ST STE H",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125241791",
            "telephone_number": "845-896-6700",
            "fax_number": "845-896-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 MAIN ST STE H",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125241791",
            "telephone_number": "845-896-6700",
            "fax_number": "845-896-6882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "WEIXUN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-27",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishkill, NY

Sources for this page

Verify at the official NPI Registry.