Jake Xiao Wang, MD, MHS

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

35145662 Issued in OH

Practice address

2820 W Market St Ste 210
Fairlawn, OH 44333-4092

Phone

(440) 848-3567

NPI assigned

Jun 12, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Dermatology

Education

Yale University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.19 of 100Reported as group

Quality

63.13

Promoting interoperability

100

Improvement activities

40

Cost

74.18

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwang36687@ehrdirect.uhhospitals.org

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.

• University Hospitals Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1669499414

  Dermatology

  Medicare reassignment Care Compare group NPD
• Multicare Health System

  • Nurse Practitioner
  • Tacoma, WA
  • NPI 1407808413
  NPD (past)

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1780114876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 W MARKET ST STE 210",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 W MARKET ST STE 210",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334092",
            "telephone_number": "440-848-3567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Temple St Ste 5A",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065102745",
            "country_code": "US",
            "telephone_number": "203-824-7059",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 Brookline Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022155400",
            "country_code": "US",
            "telephone_number": "617-667-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 York St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "06510",
            "country_code": "US",
            "telephone_number": "203-688-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "JAKE",
        "middle_name": "XIAO",
        "name_prefix": "Dr.",
        "credential": "MD, MHS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-12",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "68092",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "272225",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "OH",
            "license": "35145662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cordell Walker Sr.
• Damarios Walker
• Jetaviea Walker
• Marcus Walker
• Sharilissa Walker
• Warby Parker Inc.
• Chelsea Warnecke, D.C.
• Jill Marie Warner, CNP
• Kelsey Moyra Washko, OTR/L
• Kelsey Way

• MOHS-Micrographic Surgery Physician in Fairlawn, OH
• Providers in Fairlawn, OH by specialty
• MOHS-Micrographic Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.