Individual provider Active NPI

Meng-Chun Wang, PT, CHT

  • Physical Therapist
  • Milwaukee, WI
National Provider Identifier
1023032299
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11121 Issued in WI
Practice address
2801 W Kinnickinnic River Pkwy Ste 370
Milwaukee, WI 53215-3678
Phone
(414) 649-7900
Fax
(414) 649-7499
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Physical Therapist 2251H1200X PT007664 OH
Physical Therapist 225100000X 11121 WI Primary

Addresses

Primary practice location

2801 W Kinnickinnic River Pkwy Ste 370
Milwaukee, WI 53215-3678

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (414) 649-7900

Other practice location 1

500 E Main St
Suite 102
Columbus, OH 43215-5369
Phone (614) 221-2692

Other identifiers 1

IdentifierTypeStateIssuer
100060512MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mwang2015@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210504001004 WI Practitioner - Physical Therapist in Private Practice 5698772465 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT007664OHMDHand Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince May 1, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince May 1, 2021 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Ohio Centers for Hand & Physical Rehabilitation, LLC Physical Therapist Past Accepting new patients

Locations

2801 W Kinnickinnic River Pkwy
Ste 370
Milwaukee, WI 53215
Phone (414) 649-1280

2801 W Kinnickinnic River Pkwy
Milwaukee, WI 53215
Phone (414) 384-5111

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

Interoperability endpoints

  • Direct secure messaging: mwang2015@direct.myadvocateaurora.org

Organizations & group practices 4

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1023032299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-649-7900",
            "fax_number": "414-649-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W KINNICKINNIC RIVER PKWY STE 370",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153678",
            "telephone_number": "414-649-7900",
            "fax_number": "414-649-7499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 E Main St",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432155369",
            "country_code": "US",
            "telephone_number": "614-221-2692",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "MENG-CHUN",
        "credential": "PT, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251H1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Hand",
            "state": "OH",
            "license": "PT007664",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100060512",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwang2015@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 370",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153678",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2801 W Kinnickinnic River Pkwy Ste 370",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.