Kamille Wang

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

851 Gov Carlos G Camacho Rd
Tamuning, GU 96913-3153

Phone

(671) 649-5018

NPI assigned

Apr 10, 2024

Last updated

Apr 10, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GU

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Doctors ClinicGroup PAC ID 3779472584, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• The Doctors Clinic

  • Family Medicine Physician
  • Tamuning, GU
  • NPI 1467503433
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1712707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1346093259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 KAYON PATNITOS APT 114",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "969297522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 GOV CARLOS G CAMACHO RD",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133153",
            "telephone_number": "671-649-5018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "KAMILLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vik Management, Inc. (ITC Pharmacy I)
• Vik Management, Inc. (ITC Pharmacy II)
• Jonathan Visscher, D.D.S.
• Nam Vo, PHARMD.
• Kimberly R Walton, MD
• Karla De Guzman Wang, PA-C
• Wayne Ward, DDS.
• Gregory Warner, RPH
• Westcare Pacific Islands
• Westpac Hematology & Oncology Center Inc (Cancer Center of Guam)

• Physician Assistant in Tamuning, GU
• Providers in Tamuning, GU by specialty
• Physician Assistant in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.