|Provider Name||JAMES T WANG M.D.|
|Location Address||29833 SANTA MARGARITA PKWY 100 RANCHO SANTA MARGARITA, CA 92688|
|Location Phone||(949) 888-9288|
|Mailing Address||29833 SANTA MARGARITA PKWY 100 RANCHO SANTA MARGARITA, CA 92688|
|NPI Entity Type||Individual|
|Medical School Name||UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE|
|Is Sole Proprietor?||No|
|Last Update Date||03-22-2021|
A dermatologist like James T Wang M.d. is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.James Wang is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
James Wang is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 90.3, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance. The provider also has detailed performance information the following quality measures: advance care plan, advance care planning, clinical data registry reporting, depression screening, documentation of current medications in the medical record, engagement of new medicaid patients and follow-up, engagement of patients through implementation of improvements in patient portal, e-prescribing, implementation of medication management practice improvements, melanoma: continuity of care - recall system, one-time screening for hepatitis c virus (hcv) for patients at risk, pain assessment and follow-up, pneumococcal vaccination status for older adults, preventive care and screening: screening for depression and follow-up plan, preventive care and screening: unhealthy alcohol use: screening & brief counseling, provide patients electronic access to their health information, security risk analysis, tobacco use and unhealthy alcohol use.
The typical physician office visit costs for Medicare beneficiaries in this area are: $24.87 for a new patient copayment and $20.28 for an established patient copayment.
The CLIA number of James T Wang M.d. is 05D1021032 registered as a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued to James T Wang M.d. after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
|Type||Allopathic & Osteopathic Physicians|
|Taxonomy Description||A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.|
JAMES T WANG M.D.
29833 SANTA MARGARITA PKWY
RANCHO SANTA MARGARITA, CA
Phone: (949) 888-9288
Fax: (949) 888-8918
JAMES T WANG M.D.
29833 SANTA MARGARITA PKWY
RANCHO SANTA MARGARITA, CA
Phone: (949) 888-9288
Fax: (949) 888-8918
17822 Beach Blvd Ste 468
Huntington Beach, CA 92647
PECOS Enrollment and Medicare Participation Status
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
|Registered in PECOS?||Yes|
|PECOS PAC ID||4688669864|
|PECOS Enrollment ID||I20040421000561|
|Accepts Medicare Assignment?|| Yes "What does it mean "accepts medicare assignment"?|
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
|Eligible order / refer Part B Clinical Laboratory and Imaging||Yes|
|Eligible order / refer Durable Medical Equipment||Yes|
|Eligible order / refer Home Health Agency (HHA)||Yes|
|Eligible order / refer Power Mobility Devices||Yes|
Physician Office Visit Costs
The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 92688 ZIP code area.
|New Patients Office Visits Costs *|
|Most Utilized Procedure Code for new patients office visits: 99203|
|Minimum New Patient Pricing||Maximum New Patient Pricing||Typical New Patient Pricing|
|Minimum New Patient Copayment||Maximum New Patient Copayment||Typical New Patient Copayment|
|Established Patients Office Visits Costs *|
|Most Utilized Procedure Code for established patients office visits: 99213|
|Minimum Established Patient Pricing||Maximum Established Patient Pricing||Typical Established Patient Pricing|
|Minimum Established Patient Copayment||Maximum Established Patient Copayment||Typical Established Patient Copayment|
* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
|MIPS Measure||Score Weight||Score|
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
|Promoting Interoperability (PI)||25%||91|
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
|MIPS Final Score||-||90.3|
|The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.|
MIPS Quality Measures
The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.
|Quality Measure||Performance||Number of Patients|
|Advance Care Plan||35%||544|
|Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record or documentation in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan|
|Advance Care Planning||Yes||N/A|
|Implementation of practices/processes to develop advance care planning that includes: documenting the advance care plan or living will within the medical record, educating clinicians about advance care planning motivating them to address advance care planning needs of their patients, and how these needs can translate into quality improvement, educating clinicians on approaches and barriers to talking to patients about end-of-life and palliative care needs and ways to manage its documentation, as well as informing clinicians of the healthcare policy side of advance care planning.|
|Clinical Data Registry Reporting||Yes||N/A|
|The MIPS eligible clinician is in active engagement to submit data to a clinical data registry.|
|Depression screening and follow-up plan: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including depression screening and follow-up plan (refer to NQF #0418) for patients with co-occurring conditions of behavioral or mental health conditions.|
|Documentation of Current Medications in the Medical Record||93%||5818|
|Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration|
|Engagement of New Medicaid Patients and Follow-up||Yes||N/A|
|Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.|
|Engagement of patients through implementation of improvements in patient portal||Yes||N/A|
|Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence.|
|At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using CEHRT.|
|Implementation of medication management practice improvements||Yes||N/A|
|Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/orConduct periodic, structured medication reviews.|
|Melanoma: Continuity of Care - Recall System||11%||70|
|Percentage of patients, regardless of age, with a current diagnosis of melanoma or a history of melanoma whose information was entered, at least once within a 12 month period, into a recall system that includes:- A target date for the next complete physical skin exam, AND- A process to follow up with patients who either did not make an appointment within the specified timeframe or who missed a scheduled appointment|
|One-Time Screening for Hepatitis C Virus (HCV) for Patients at Risk||1%||609|
|Percentage of patients aged 18 years and older with one or more of the following: a history of injection drug use, receipt of a blood transfusion prior to 1992, receiving maintenance hemodialysis, OR birthdate in the years 1945-1965 who received one-time screening for hepatitis C virus (HCV) infection|
|Pain Assessment and Follow-Up||0%||5818|
|Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present|
|Pneumococcal Vaccination Status for Older Adults||29%||544|
|Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine|
|Preventive Care and Screening: Screening for Depression and Follow-Up Plan||60%||2224|
|Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen|
|Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling||68%||1374|
|Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user|
|Provide Patients Electronic Access to Their Health Information||76%||1808|
|For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient-authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified electronic health record technology (CEHRT).|
|Security Risk Analysis||Yes||N/A|
|Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified electronic health record technology (CEHRT) in accordance with requirements in 45 CFR 164.312(a)(2)(iv) and 164.306(d)(3), implement security updates as necessary, and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.|
|Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence.|
|Unhealthy alcohol use||Yes||N/A|
|Unhealthy alcohol use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including screening and brief counseling (refer to NQF #2152) for patients with co-occurring conditions of behavioral or mental health conditions.|
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.
- 159Pathology examination of tissue using a microscope, intermediate complexity (HCPCS:88305)
- 65Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
- 37Destruction of up to 14 skin growths (HCPCS:17110)
- 36Biopsy of single growth of skin and/or tissue (HCPCS:11100)
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1013091396 is:
|Facility Type||PHYSICIAN OFFICE|
|Certificate Type||Certificate of Compliance|
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
|No.||Taxonomy Code||Type||Classification||Specialization||License No.||State||Primary|
|1||207ND0101X||Allopathic & Osteopathic Physicians||Dermatology||MOHS-Micrographic Surgery||G79462||CA||No|
Taxonomy Description: the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
|2||207ND0900X||Allopathic & Osteopathic Physicians||Dermatology||Dermatopathology||G79462||CA||No|
Taxonomy Description: a dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes.
|3||207NP0225X||Allopathic & Osteopathic Physicians||Dermatology||Pediatric Dermatology||G79462||CA||No|
Taxonomy Description: a pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents.
|4||207NS0135X||Allopathic & Osteopathic Physicians||Dermatology||Procedural Dermatology||G79462||CA||No|
Taxonomy Description: procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
NPI Validation Check Digit Calculation
|Step 1: Double the value of the alternate digits, beginning with the rightmost digit.|
|2 + 0 + 2 + 3 + 0 + 9 + 2 + 3 + 1 + 8 + 24 = 54|
|60 - 54 = 6||6|
The NPI number 1013091396 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
|NPI||Name / Type||Taxonomy||Address|
|1831282300||DR. HECTOR GUSTAVO RAMIREZ JR. M.D. |
|Family Medicine||29833 SANTA MARGARITA PKWY SUITE 200|
RANCHO SANTA MARGARITA, CA 92688
|1851457485||HECTOR G. RAMIREZ, M.D., INC. |
|Family Medicine||29833 SANTA MARGARITA PKWY STE. 200|
RANCHO SANTA MARGARITA, CA 92688
|1366645145||JAMES T WANG MD INC |
|Dermatology||29833 SANTA MARGARITA PKWY SUITE 100|
RANCHO SANTA MARGARITA, CA 92688
Frequently Asked Questions
What is James Wang M.D. NPI number?
The NPI number assigned to James Wang M.D. is 1013091396, registered as an "individual" on October 24, 2006
Where is James Wang M.D. located?
The provider is located at 29833 Santa Margarita Pkwy 100 Rancho Santa Margarita, Ca 92688 and the phone number is (949) 888-9288
Which is James Wang M.D. specialty?
The provider's speciality is Dermatology
How many years of experience does James Wang M.D. have?
The provider has more than 31 years of experience. He graduated from University Of California, Geffen School Of Medicine in 1992.
Is James Wang M.D. registered in PECOS?
Yes, as of November 14, 2022 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
How much is a visit to James Wang M.D.?
Medicare beneficiaries should expect a typical cost of $99.5 with an average copayment of $24.87 for new patient appointments. Established patients should expect a typical charge of $81.14 and an average copayment of 20.28. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by James Wang M.D.?
The most common procedures or services performed by this practitioner are: Pathology examination of tissue using a microscope, intermediate complexity, Injection, triamcinolone acetonide, not otherwise specified, 10 mg, Destruction of up to 14 skin growths and Biopsy of single growth of skin and/or tissue.
What is James Wang M.D. CLIA number?
The provider's CLIA number is 05D1021032 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
How do I update my NPI information?
The NPI record of James Wang M.D. was last updated on October 24, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]