Chih Jen Wang, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-009615 Issued in IL

Practice address

1560 W US Highway 50
O Fallon, IL 62269-1619

Phone

(618) 397-6575

Fax

(800) 432-6004

NPI assigned

May 12, 2006

Last updated

Feb 14, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

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 2

Specialty

Optometry

Education

Indiana University - School of Optometry, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nucrown, LLCGroup PAC ID 1456256346, 22 clinicians

Christina J. Levi O D P C.Group PAC ID 9436210762, 63 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Christina J. Levi O D P C

  dba Edwardsville Vision Center

  • Optometrist
  • Edwardsville, IL
  • NPI 1477703411
  Medicare reassignment Care Compare group NPD
• Nu-Crown, LLC

  dba Crown Optical

  • Optometrist
  • Alton, IL
  • NPI 1295737294

  MO

  Medicare reassignment Care Compare group NPD
• Paige Hedgpath OD,PC

  dba Eyes On Missouri

  • Optometrist
  • Jefferson City, MO
  • NPI 1962644732
  Medicare reassignment NPD
• Nucrown,Inc.

  dba Crown Optical

  • Optometrist
  • Saint Charles, MO
  • NPI 1114337102
  NPD
• Paige Hedgpath Odpc

  dba Eyes On Missouri

  • Optometrist
  • Columbia, MO
  • NPI 1669530887
  NPD
• Christina J. Levi O D P C

  dba Edwardsville Vision Center

  • Optometrist
  • Edwardsville, IL
  • NPI 1033261904
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1861443079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E BROADWAY",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026220",
            "telephone_number": "800-407-2696",
            "fax_number": "800-432-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 W US HIGHWAY 50",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691619",
            "telephone_number": "618-397-6575",
            "fax_number": "800-432-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "CHIH JEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009615",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2004001752",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009615",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00403017",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cierra Walters, PT, DPT
• Sydney Rose Walters
• Christine Walthes, APRN, FNP-C
• Katarina Waltman, RBT
• Walton CS XII PC (May Chiropractic)
• Waning Moon LLC
• Allison Renee Washenko
• Washington University Physicians in Illinois, Inc
• Washington University Physicians in Illinois, Inc
• Washington University Physicians in Illinois, Inc.

• Optometrist in O'Fallon, IL
• Providers in O'Fallon, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; 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.