Paul Wang, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036092209 Issued in IL

Practice address

104 W 18TH Ave
Coal Valley, IL 61240-9337

Phone

(309) 799-7518

Fax

(309) 799-3886

NPI assigned

Feb 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in IL

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

Family Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Advanced Physical Therapy Services, LTD.Group PAC ID 9133101462, shared by 5 NPIs, 216 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unity Point at Home Home health agency, Moline, IL, CCN 147009
• Hospice Compassus - Northwest Illinois Hospice, Galesburg, IL, CCN 141581
• Trinity Rock Island Hospital, Rock Island, IL, CCN 140280
• Trinity - Bettendorf Hospital, Bettendorf, IA, CCN 160104
• Arcadia Care Rock Island Nursing home, Rock Island, IL, CCN 145950

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pwang92556@direct.unitypoint.org

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.

• Iowa Physicians Clinic Medical Foundation

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274

  Family Medicine, IL

  Medicare reassignment Care Compare group NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

• Community Hospices of America, LLC

  • Community Based Hospice Care Agency
  • Galesburg, IL
  • NPI 1063514800
  Care Compare affiliation
• Generations at Rock Island, LLC

  • Skilled Nursing Facility
  • Rock Island, IL
  • NPI 1861537250

  Nursing home

  Care Compare affiliation
• Trinity Medical Center

  • General Acute Care Hospital
  • Rock Island, IL
  • NPI 1316047632
  Care Compare affiliation
• Unitypoint at Home

  • Home Health Agency
  • Moline, IL
  • NPI 1427351956
  Care Compare affiliation
• Trinity Medical Center

  • General Acute Care Hospital
  • Bettendorf, IA
  • NPI 1124110820
  Care Compare affiliation

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1508839481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W 18TH AVE",
            "city": "COAL VALLEY",
            "state": "IL",
            "postal_code": "612409337",
            "telephone_number": "309-799-7518",
            "fax_number": "309-799-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 18TH AVE",
            "city": "COAL VALLEY",
            "state": "IL",
            "postal_code": "612409337",
            "telephone_number": "309-799-7518",
            "fax_number": "309-799-3886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036092209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE NUMBER",
            "identifier": "4255D7",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS WELLMARK",
            "identifier": "91488",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "60636",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHS",
            "identifier": "143603",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508839481",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "80096082",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "2263301",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naomi Sanderson, LMSW
• Tracy J Sorrell, PTA
• Rhonda Jo Sowards, MD
• Kathy Stegle, PT
• The Robert Young Center for Community Mental Health
• Beth Ann Weiss
• Constance Williams, QMHP
• Joan Marie Wright, COTA/L

• Family Medicine Physician in Coal Valley, IL
• Providers in Coal Valley, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.