Individual provider Active NPI

Chao Vang, DPM

  • Podiatrist
  • Pekin, IL
National Provider Identifier
1740241967
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016004868 Issued in IL
Practice address
1503 Valle Vista Blvd Ste C
Pekin, IL 61554-6239
Phone
(309) 347-6121
Fax
(309) 347-8010
NPI assigned
Mar 29, 2006
Last updated
Sep 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016004868 IL Primary

Addresses

Primary practice location

1503 Valle Vista Blvd Ste C
Pekin, IL 61554-6239

Mailing address

1503 Valle Vista Blvd Ste C
Pekin, IL 61554-6239
Phone (309) 347-6121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20080130000282 IL Practitioner - Podiatry 6800978818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1503 Valle Vista Blvd
Suite C
Pekin, IL 61554-6239
Phone (309) 347-6121

Merit-based Incentive Payment System (MIPS)

Final score
99.74 of 100Reported as individual
Quality
95
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue346
Removal of skin lesions1-10
Removal of nail tissue1529
Removal or shaving of skin growth288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pekin Podiatric Medical Center, P.C Podiatrist CurrentSince Jul 1, 1998 Accepting new patients

Locations

1503 Valle Vista Blvd
Ste C
Pekin, IL 61554
Phone (309) 347-6121

1505 Valle Vista Blvd
Pekin, IL 61554
Phone (309) 347-6121

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.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1740241967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 VALLE VISTA BLVD STE C",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546239",
            "telephone_number": "309-347-6121",
            "fax_number": "309-347-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 VALLE VISTA BLVD STE C",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546239",
            "telephone_number": "309-347-6121",
            "fax_number": "309-347-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANG",
        "first_name": "CHAO",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016004868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pekin, IL

Sources for this page

Verify at the official NPI Registry.