Jesse Richard Wang, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

35781 Issued in CA

Practice address

3801 Miranda Ave
Palo Alto, CA 94304-1290

Phone

(206) 890-5076

NPI assigned

Jul 6, 2024

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 CA

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

State University of New York - State College Optometry, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

First Optometric Care of Northern California PCGroup PAC ID 6002216488, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• First Optometric Care of Northern California PC

  • Optometrist
  • Rancho Cordova, CA
  • NPI 1154972404
  Medicare reassignment Care Compare group NPD
• Lucy Wun OD, Inc

  • Optometrist
  • Cupertino, CA
  • NPI 1740629294
  Medicare reassignment NPD
• First Optometric Care of Northern California PC

  • Optometrist
  • San Jose, CA
  • NPI 1487537452
  NPD
• First Optometric Care of Northern California PC

  • Optometrist
  • Cupertino, CA
  • NPI 1255142980
  NPD (past)
• First Optometric Care of Northern California PC

  • Optometrist
  • Redwood City, CA
  • NPI 1932794419
  NPD (past)

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

{
    "created_epoch": "1720224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720224000000",
    "number": "1669218913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4217 170TH PL SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980373128",
            "telephone_number": "206-890-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 MIRANDA AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041290",
            "telephone_number": "206-890-5076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "JESSE",
        "middle_name": "RICHARD",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-06",
        "last_updated": "2024-07-06",
        "certification_date": "2024-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "35781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Ya-Ping Wang, MD
• Fiona KJ Wang, PA-C
• Huichi Wang, PA-C, FNP
• Jackie Yixian Wang, MD
• Jennifer Wang
• Jessica Jiadai Wang, MD
• Katarina Wang, MD
• Kenneth Wang
• Leah Alyssa Wang, PHD
• Maggie Wang, PSY.D.

• Optometrist in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2024; 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.