Individual provider Active NPI

Edina Cindy Wang

  • Radiation Oncology Physician
  • Saint Louis, MO
National Provider Identifier
1538698758
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
2024022803 Issued in MO
Practice address
10050 Kennerly Rd
Saint Louis, MO 63128-2192
Phone
(314) 525-1688
Fax
(314) 525-1689
NPI assigned
Jun 9, 2017
Last updated
Jul 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 036169373 IL
Radiation Oncology Physician 2085R0001X 2024022803 MO Primary

Addresses

Primary practice location

10050 Kennerly Rd
Saint Louis, MO 63128-2192

Mailing address

11475 Olde Cabin Rd Ste 200
Saint Louis, MO 63141-7129
Phone (314) 991-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, 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
I20240625003324 MO Practitioner - Radiation Oncology 4183997463 Reassigns benefits to 2 organizations
I20240701001475 IL Practitioner - Radiation Oncology 4183997463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Wake Forest University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West County Radiological Group IncGroup PAC ID 8527966944, 105 clinicians

Practice addresses (Care Compare)

10050 Kennerly Rd
Saint Louis, MO 63128-2192
Phone (314) 525-1688

6836 State Route 162
Maryville, IL 62062-8500
Phone (618) 288-9044

901 Patients 1St Dr
Washington, MO 63090-4700
Phone (636) 231-6252

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West County Radiological Group, Inc. Radiation Oncology CurrentSince Jul 1, 2024 Accepting new patients

Locations

6836 State Route 162
Maryville, IL 62062
Phone (618) 277-5882

630 NW Englewood Rd
Kansas City, MO 64118
Phone (816) 453-2700

10050 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1688

11475 Olde Cabin Rd
Ste 200
Saint Louis, MO 63141
Phone (314) 991-8200

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

901 Patients First Dr
Washington, MO 63090
Phone (636) 239-7500

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1538698758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11475 OLDE CABIN RD STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417129",
            "telephone_number": "314-991-8200",
            "fax_number": "314-991-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10050 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282192",
            "telephone_number": "314-525-1688",
            "fax_number": "314-525-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "EDINA",
        "middle_name": "CINDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "036169373",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "2024022803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.