Individual provider Active NPI

Tina C Wang, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1609058973
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125047528 Issued in IL
Practice address
211 E Ohio St Apt 1617
Chicago, IL 60611-3235
Phone
(312) 464-9850
NPI assigned
Nov 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125047528 IL Primary

Addresses

Primary practice location

211 E Ohio St Apt 1617
Chicago, IL 60611-3235

Mailing address

211 E Ohio St Apt 1617
Chicago, IL 60611-3235
Phone (312) 464-9850

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
I20080806000801 CA Practitioner - Emergency Medicine 3678647799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burbank Emergency Medical Group IncGroup PAC ID 2961308036, 29 clinicians

Practice addresses (Care Compare)

501 S Buena Vista St
Burbank, CA 91505-4809
Phone (818) 843-5111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.12 of 100Reported as group
Quality
77.79
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125047528ILMDEmergency Medicine Physician

Interoperability endpoints

  • Direct secure messaging: twang433978@oc.providencedirect.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1609058973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E OHIO ST APT 1617",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113235",
            "telephone_number": "312-464-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E OHIO ST APT 1617",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113235",
            "telephone_number": "312-464-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "TINA",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125047528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.