Individual provider Active NPI

Roger Hsio-Hsion Wang, M.D.

  • Adult Medicine Physician
  • Santa Ana, CA
National Provider Identifier
1982602579
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
A44667 Issued in CA
Practice address
1125 E 17TH St
Suite W239
Santa Ana, CA 92701-2201
Phone
(714) 835-1818
Fax
(714) 835-7200
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X A44667 CA Primary

Addresses

Primary practice location

1125 E 17TH St
Suite W239
Santa Ana, CA 92701-2201

Mailing address

1125 E 17TH St
Suite W239
Santa Ana, CA 92701-2201
Phone (714) 835-1818

Other identifiers 2

IdentifierTypeStateIssuer
A44667OtherCAPHYSICIAN LICENSE
00A446670MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120119000476 CA Practitioner - Family Practice 2769659580 Reassigns benefits to 1 organization
Practice locations: Santa Ana, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44667CAMDDentist
A44667CAMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathway Medical Group, Inc. CurrentSince Jun 1, 2018 Accepting new patients
Pathway Medical Group, Inc CurrentSince Jun 1, 2018 Accepting new patients
Pathway Medical Group, Inc Current Accepting new patients
Providence Medical Foundation Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
South Coast Global Medical Center, Inc Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients

Locations

12665 Garden Grove Blvd
Ste 502
Garden Grove, CA 92843
Phone (714) 534-3900

12665 Garden Grove Blvd
Ste 502AB
Garden Grove, CA 92843
Phone (714) 537-7800

12665 Garden Grove Blvd
Ste 502A
Garden Grove, CA 92843
Phone (714) 534-3900

Organizations & group practices 8

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1982602579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 E 17TH ST",
            "address_2": "SUITE W239",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012201",
            "telephone_number": "714-835-1818",
            "fax_number": "714-835-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E 17TH ST",
            "address_2": "SUITE W239",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012201",
            "telephone_number": "714-835-1818",
            "fax_number": "714-835-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "ROGER",
        "middle_name": "HSIO-HSION",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "A44667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "A44667",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A446670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.