Walter Pang, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

885 Issued in MS

Practice address

815 Highway 80 E
Clinton, MS 39056-5252

Phone

(601) 924-4444

Fax

(601) 924-4100

NPI assigned

Aug 6, 2013

Last updated

Aug 6, 2013By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Horn Lake Eyecare, PLLCGroup PAC ID 4486889284, 3 clinicians

Olive Branch Eyecare, PLLCGroup PAC ID 4981797297, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: walter.pang.1@20428.direct.athenahealth.com

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.

• Horn Lake Eyecare PLLC

  • Optometrist
  • Horn Lake, MS
  • NPI 1609116581
  Medicare reassignment Care Compare group NPD
• Olive Branch Eyecare, PLLC

  • Optometrist
  • Olive Branch, MS
  • NPI 1003019878
  Medicare reassignment Care Compare group NPD
• Desoto Family Vision PLLC

  • Optometrist
  • Southaven, MS
  • NPI 1679348924
  Medicare reassignment NPD
• Magnolia Dermatology, PLLC

  • Dermatology Physician
  • Clinton, MS
  • NPI 1841645470
  NPD (past)

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375747200000",
    "number": "1548692130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 DOGWOOD LN",
            "city": "BATESVILLE",
            "state": "MS",
            "postal_code": "386069331",
            "telephone_number": "601-924-4444",
            "fax_number": "601-924-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 HIGHWAY 80 E",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565252",
            "telephone_number": "601-924-4444",
            "fax_number": "601-924-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANG",
        "first_name": "WALTER",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-06",
        "last_updated": "2013-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnnie Mae Owens, CNA CHILD CARE CREDE
• Tonia Rene Owens
• Jada Palmer
• Jakayla Palmer
• Palmetto Senior Care (Home Instead Senior Care)
• Bobby C Pankey, O.D.
• Dillon J Pankey, OD
• Park Dental Group - Clinton PLLC
• Jessica Parker, PTA
• David King Parks, DMD

• Optometrist in Clinton, MS
• Providers in Clinton, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; 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.