Michael Wang

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MICHAEL WANG

Practice address

9727 Elk Grove Florin Rd Ste 190
Elk Grove, CA 95624-2267

Phone

(916) 686-5165

Fax

(916) 686-5865

NPI assigned

Oct 15, 2018

Organization subpart

No

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

Authorized official

Name

Lynn Buttino, ODNPI 1578657573

Title

Partner

Phone

(916) 686-5165

Specialties & licenses 1

Addresses

Other names 2

• Wang Optometry Doing business as
• Michael Wang, OD Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

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

• Lynn M Buttino, O.D.

  • Optometrist
  • Elk Grove, CA
  • NPI 1578657573
  Medicare reassignment Care Compare group NPD Authorized official
• Michael Wang, OD.

  • Optometrist
  • Elk Grove, CA
  • NPI 1104820950
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1952877102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9727 ELK GROVE FLORIN RD STE 190",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956242267",
            "telephone_number": "916-686-5165",
            "fax_number": "916-686-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9727 ELK GROVE FLORIN RD STE 190",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956242267",
            "telephone_number": "916-686-5165",
            "fax_number": "916-686-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL WANG",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-15",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "BUTTINO",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "916-686-5165",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wang Optometry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Michael Wang, OD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melissa Meredith
• Monique Merrill
• Lilibeth Mesa
• Alexandra Elizabeth Mesghina
• Odalina Meza
• Harissa Andrea Michael, O.D.
• Richard Read Michelsen, D.D.S.
• Brittany Lorraine Miele
• Maria Luisa Mier-Bautista, D.M.D.
• Brett Mifune Jr

• Optometrist in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.