Organization Active NPI

Jinmei Woan MD a Professional Corporation

  • Neurology Physician
  • Tracy, CA
National Provider Identifier
1831130574
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G69222 Issued in CA
Legal business name
JINMEI WOAN MD A PROFESSIONAL CORPORATION
Practice address
530 W Eaton Ave
Suite M
Tracy, CA 95376-3400
Phone
(209) 833-0268
Fax
(209) 833-7880
NPI assigned
Jun 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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

Authorized official

Name
Jinmei Woan, MDNPI 1093756835
Title
President of Corporation
Phone
(209) 833-0268

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X G69222 CA Primary

Addresses

Primary practice location

530 W Eaton Ave
Suite M
Tracy, CA 95376-3400

Mailing address

PO Box 1955
Tracy, CA 95378-1955
Phone (209) 833-0268

Other identifiers 2

IdentifierTypeStateIssuer
00G692220OtherCAMEDICARE PROVIDER ID
00G692221MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091020000135 CA Part B Supplier - Clinic/Group Practice 0143367482 Receives reassigned benefits from 1 practitioner
Practice locations: Tracy, CA

National Provider Directory

National Provider Directory

Locations

530 W Eaton Ave
Ste M
Tracy, CA 95376
Phone (209) 833-0268

451 W Eaton Ave
Tracy, CA 95376
Phone (209) 833-0268

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1831130574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1955",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953781955",
            "telephone_number": "209-833-0268",
            "fax_number": "209-833-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 W EATON AVE",
            "address_2": "SUITE M",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763400",
            "telephone_number": "209-833-0268",
            "fax_number": "209-833-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JINMEI WOAN MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "WOAN",
        "authorized_official_first_name": "JINMEI",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "209-833-0268",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G69222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER ID",
            "identifier": "00G692220",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G692221",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.