Chiachien Jake Wang, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

304912 Issued in LA

Practice address

2600 Kings Hwy
Shreveport, LA 71103-3950

Phone

(318) 212-4639

Fax

(318) 212-8305

NPI assigned

Jun 26, 2012

Last updated

Apr 27, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Radiation Oncology

Education

University of Connecticut School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WK Radiation Oncology ServicesGroup PAC ID 2365752409, 4 clinicians

Radiation Oncology Services ApmcGroup PAC ID 9436124997, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Radiation Oncology Services Apmc

  • Radiation Oncology Physician
  • Shreveport, LA
  • NPI 1669564258
  Medicare reassignment Care Compare group NPD
• WK Radiation Oncology Services

  • Radiation Oncology Physician
  • Shreveport, LA
  • NPI 1922478304
  Medicare reassignment Care Compare group NPD
• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Willis Knighton Medical Center, Inc.

  dba WK Bossier Health Center

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba Willis Knighton South Hospital

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Pierremont Health Center

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1457615395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1684",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711651684",
            "telephone_number": "318-424-4088",
            "fax_number": "855-230-1466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033950",
            "telephone_number": "318-212-4639",
            "fax_number": "318-212-8305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5801 Forest Park Rd",
            "address_2": "Moncrief Radiation Oncology Center at UTSW",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752356403",
            "country_code": "US",
            "telephone_number": "214-645-8559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "CHIACHIEN",
        "middle_name": "JAKE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-26",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10047559",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "LA",
            "license": "304912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Glen Walton, M.D.
• Robert Walton
• Shadreka Walton
• Crystal Dawn Waltower, LOTR
• Nitin Walyat, MD
• Haibo Wang, MD
• Hao Wang
• Yuqing Wang, MD
• Keith Alexius Wangkay, MD
• Muhammad Waqas, MD

• Radiation Oncology Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Radiation Oncology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; 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.