Individual provider Active NPI

Wai Kan Chiu, M.D., PH.D.

  • Gastroenterology Physician
  • Cameron Park, CA
National Provider Identifier
1801258686
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
177179 Issued in CA
Practice address
3501 Palmer Dr Ste 201
Cameron Park, CA 95682-8276
Phone
(530) 626-2611
Fax
(212) 746-3609
NPI assigned
Mar 22, 2016
Last updated
Oct 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 177179 CA Primary

Addresses

Primary practice location

3501 Palmer Dr Ste 201
Cameron Park, CA 95682-8276

Mailing address

PO Box 45680
San Francisco, CA 94145-0680
Phone (530) 626-2787

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
I20220620001004 CA Practitioner - Gastroenterology 9436497062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Pittsburgh School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Marshall Medical CenterGroup PAC ID 7517875859, 168 clinicians

Practice addresses (Care Compare)

3501 Palmer Dr
Suite 201
Cameron Park, CA 95682-8276
Phone (530) 672-7040

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy350
Upper gastrointestinal (GI) endoscopy for acid reflux170

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
177179CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Medical Center CurrentSince Jul 1, 2022 Accepting new patients
Marshall Medical Center Gastroenterology CurrentSince Jul 1, 2022 Accepting new patients
Marshall Medical Center Past Accepting new patients

Locations

3501 Palmer Dr
Cameron Park, CA 95682

3501 Palmer Dr
Ste 201
Cameron Park, CA 95682
Phone (530) 626-2611

3501 Palmer Dr
Ste 204
Cameron Park, CA 95682
Phone (530) 626-9488

1004 Fowler Way
Ste 4
Placerville, CA 95667
Phone (530) 626-9488

1095 Marshall Way
Ste 201
Placerville, CA 95667
Phone (530) 344-5470

Organizations & group practices 3

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.

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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1801258686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45680",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941450680",
            "telephone_number": "530-626-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 PALMER DR STE 201",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956828276",
            "telephone_number": "530-626-2611",
            "fax_number": "212-746-3609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIU",
        "first_name": "WAI KAN",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "177179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cameron Park, CA

Sources for this page

Verify at the official NPI Registry.