Connie Mengyan Wang, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

Q9076 Issued in TX

Practice address

4603 FM 1463 Rd Ste 100
Katy, TX 77494-6545

Phone

(281) 612-0050

NPI assigned

Apr 28, 2013

Last updated

Mar 5, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Baylor College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elite Dermatology, PLLCGroup PAC ID 8729345285, 26 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Elite Dermatology, PLLC

  • Dermatology Physician
  • Katy, TX
  • NPI 1104337526
  Medicare reassignment Care Compare group NPD Authorized official
• Elite Derm Services, PLLC

  • Dermatopathology (Pathology) Physician
  • Fulshear, TX
  • NPI 1861209298
  NPD

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

{
    "created_epoch": "1367107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520208000000",
    "number": "1003250457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4603 FM 1463 RD STE 100",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946545",
            "telephone_number": "281-612-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4603 FM 1463 RD STE 100",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946545",
            "telephone_number": "281-612-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "CONNIE",
        "middle_name": "MENGYAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-28",
        "last_updated": "2018-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "Q9076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jheri Walters, LCSW-S
• Dawnna Marie Walton, M.D.
• Sam Wan, CMT
• Bing Qing Wang, DDS
• Chang Wang
• Fangping Chen Wang, PT, PH. D.
• Huiqin Wang
• Jessica Wang
• Laura Wang, M.D.
• Leticia Wang

• Dermatology Physician in Katy, TX
• Providers in Katy, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2018; 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.