Individual provider Active NPI

Jonathan Wang, M.D.

  • Orthopaedic Surgery Physician
  • St Charles, IL
National Provider Identifier
1376864884
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036.175919 Issued in IL
Practice address
2900 Foxfield Rd Ste 102
St Charles, IL 60174-5799
Phone
(877) 377-1188
Fax
(630) 377-7360
NPI assigned
Jun 18, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036.175919 IL Primary

Addresses

Primary practice location

2900 Foxfield Rd Ste 102
St Charles, IL 60174-5799

Mailing address

2900 Foxfield Rd Ste 102
St Charles, IL 60174-5799
Phone (877) 377-1188

Other identifiers 1

IdentifierTypeStateIssuer
A110419OtherCACALIFORNIA MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130729000083 CA Practitioner - Orthopedic Surgery 6305087719 Reassigns benefits to 1 organization
I20260520002314 IL Practitioner - Orthopedic Surgery 6305087719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of California, Davis School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Orthopedics and Sports Medicine LLCGroup PAC ID 7618955808, 24 clinicians
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

2900 Foxfield Rd
Suite 102
St Charles, IL 60174-5799
Phone (630) 377-1188

4050 Dublin Blvd
Dublin, CA 94568-3112
Phone (925) 875-6100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement14
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
110419CAMDGeneral Practice Dentistry
036.175919ILMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince May 10, 2016 Accepting new patients
Sutter Bay Medical Foundation CurrentSince May 10, 2016 Accepting new patients
Genesis Orthopedics & Sports Medicine LLC Orthopaedic Surgery Past Accepting new patients
Genesis Orthopedics & Sports Medicine LLC Past Accepting new patients

Locations

20101 Lake Chabot Rd
Fl 4
Castro Valley, CA 94546
Phone (510) 204-3410

4050 Dublin Blvd
Dublin, CA 94568
Phone (925) 875-6100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

3687 Mt Diablo Blvd
Ste 200
Lafayette, CA 94549
Phone (510) 204-6660

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

12 Camino Encinas
Orinda, CA 94563
Phone (510) 204-8180

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

795 El Camino Real
#1112
Palo Alto, CA 94301

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: jwang209330@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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 6

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": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1376864884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 FOXFIELD RD STE 102",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601745799",
            "telephone_number": "877-377-1188",
            "fax_number": "630-377-7360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 FOXFIELD RD STE 102",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601745799",
            "telephone_number": "877-377-1188",
            "fax_number": "630-377-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "JONATHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-18",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036.175919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA MEDICAL LICENSE",
            "identifier": "A110419",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

Verify at the official NPI Registry.