Wan Chong Tsai, MD
Individual provider Active NPI Pediatric Pulmonology Physician · East Lansing, MI
NPI 1528074705 · NPPES record last updated Jan 10, 2022
Key facts
- NPI
- 1528074705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Pulmonology Physician 2080P0214X
- License
- 35096852 (OH)
- Practice address
- 4660 S Hagadorn Rd
Suite 405
East Lansing, MI 48823-5376 - Phone
- (517) 884-8600
- Fax
- (517) 884-8650
- NPI assigned
- Jul 31, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161123000588 | CA | Practitioner - Pediatric Medicine |
5890858187 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35096852 | OH | MD | Pediatric Pulmonology Physician |
| 4301062502 | MI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group Inc | Pediatrics | Current |
Accepting new patients |
| Permanente Medical Group Inc | Pediatrics | Current | Accepting new patients |
| Permanente Medical Group, Inc | Current |
Accepting new patients |
Locations
750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131
4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738
900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014
101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
930 W Main St
Ripon, CA 95366
Phone (209) 599-4221
1600 Eureka Rd
Roseville, CA 95661
Phone (916) 474-7777
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301062502 | MI | |
| Pediatric Pulmonology Physician | 2080P0214X | 4301062502 | MI | |
| Pediatric Pulmonology Physician | 2080P0214X | 35096852 | OH | Yes |
Addresses
Primary practice location
4660 S Hagadorn Rd
Suite 405
East Lansing, MI 48823-5376
Mailing address
804 Service Rd # A201
East Lansing, MI 48824-7015
Phone (517) 884-2976
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07089 | Other | OH | PARAMOUNT |
| 5243688 | Other | OH | AETNA |
| 3515022 | Medicaid | MI | |
| 2083392 | Medicaid | OH | |
| 1528074705 | Medicaid | MI |
Other names
- Wan Chuen Chong
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Other providers in East Lansing, MI
- Erin Cecilia Trowbridge
- Troy Gastroenterology, PC
- Heather M Trudeau
- Trunorth Integrated Therapy, PLLC
- Brian James Tsacoumangos
- Martin J Tuck
- Lakeeya K Tucker
- Nancy Tucker
- Mohammad Tuleimat
- Joshua Turchan
All providers in East Lansing, MI · Pediatric Pulmonology Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.