Individual provider Active NPI

Tei Chen Wang, M.D.

  • Internal Medicine Physician
  • West Covina, CA
National Provider Identifier
1679523906
Registry record updated Dec 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A30323 Issued in CA
Practice address
1500 W West Covina Pkwy
Ste 100
West Covina, CA 91790-2708
Phone
(626) 856-2226
Fax
(626) 960-2125
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A30323 CA Primary

Addresses

Primary practice location

1500 W West Covina Pkwy
Ste 100
West Covina, CA 91790-2708

Mailing address

8510 Balboa Blvd 150
Northridge, CA 91325-5810
Phone (818) 637-2000

Other identifiers 1

IdentifierTypeStateIssuer
00A303230MedicaidCA

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
I20100602000829 CA Practitioner - General PracticePractitioner - Family Practice 8022147909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeside Medical Organization a Medical Group IncGroup PAC ID 7618005166, 64 clinicians

Practice addresses (Care Compare)

1500 W W Covina Pkwy
West Covina, CA 91790-2708
Phone (626) 430-9991

Merit-based Incentive Payment System (MIPS)

Final score
80.57 of 100Reported as group
Quality
62.42
Promoting interoperability
76
Improvement activities
40
Cost
76.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A30323CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Medical Organization, a Medical Group Inc. Internal Medicine CurrentSince Mar 17, 2010 Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. Internal Medicine Past Accepting new patients

Locations

191 S Buena Vista St
Ste 200
Burbank, CA 91505
Phone (818) 887-2671

777 Flower St
Ste A
Glendale, CA 91201
Phone (818) 637-2000

8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000

2755 Alamo St
Ste 100
Simi Valley, CA 93065
Phone (626) 791-9004

1500 W West Covina Pkwy
Ste 100
West Covina, CA 91790
Phone (626) 338-7233

1500 W West Covina Pkwy
West Covina, CA 91790
Phone (626) 430-9991

1500 W West Covina Pkwy
Fl 1
West Covina, CA 91790

1500 W West Covina Pkwy
Ste 1021ST
West Covina, CA 91790

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: teichen.wang.p1@direct.lakeside.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449187200000",
    "number": "1679523906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8510 BALBOA BLVD 150",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913255810",
            "telephone_number": "818-637-2000",
            "fax_number": "818-654-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W WEST COVINA PKWY",
            "address_2": "STE 100",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902708",
            "telephone_number": "626-856-2226",
            "fax_number": "626-960-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "TEI CHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2015-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A30323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A303230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.