Individual provider Active NPI

Albert Cheng, MD

  • Family Medicine Physician
  • Wichita Falls, TX
National Provider Identifier
1467980763
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
BP10061265 Issued in TX
Practice address
1301 3Rd St Ste 200
Wichita Falls, TX 76301-2245
Phone
(940) 767-8334
Fax
(940) 723-4003
NPI assigned
May 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BP10061265 TX Primary

Addresses

Primary practice location

1301 3Rd St Ste 200
Wichita Falls, TX 76301-2245

Mailing address

200 Martin Luther King Blvd
Wichita Falls, TX 76301-1152
Phone (940) 767-8334

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20200910000860 CA Practitioner - Family Practice 4486072253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12100 Euclid St
Garden Grove, CA 92840-3304
Phone (888) 988-2800

23781 Maquina
Mission Viejo, CA 92691-2716
Phone (888) 988-2800

5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10061265TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Aug 3, 2020 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 3, 2020 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 3

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": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1467980763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MARTIN LUTHER KING BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763011152",
            "telephone_number": "940-767-8334",
            "fax_number": "940-723-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 3RD ST STE 200",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763012245",
            "telephone_number": "940-767-8334",
            "fax_number": "940-723-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENG",
        "first_name": "ALBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-31",
        "last_updated": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10061265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.