Individual provider Active NPI

Solange Chikando Wandji, O.D.

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1962781500
Registry record updated Feb 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG002426 Issued in PA
Practice address
2658 Germantown Ave
Philadelphia, PA 19133-1619
Phone
(267) 879-9450
NPI assigned
Aug 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002426 PA Primary

Addresses

Primary practice location

2658 Germantown Ave
Philadelphia, PA 19133-1619

Mailing address

2658 Germantown Ave
Philadelphia, PA 19133-1619
Phone (267) 879-9450

Other identifiers 1

IdentifierTypeStateIssuer
103076130MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160328000798 PA Practitioner - Optometry 6103123732 Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Optics, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1313280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456617600000",
    "number": "1962781500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2658 GERMANTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191331619",
            "telephone_number": "267-879-9450",
            "fax_number": "267-657-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2658 GERMANTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191331619",
            "telephone_number": "267-879-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANDJI",
        "first_name": "SOLANGE",
        "middle_name": "CHIKANDO",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-14",
        "last_updated": "2016-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103076130",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.