Individual provider Active NPI

Matthew Stanley Wang, M.D.

  • Vascular & Interventional Radiology Physician
  • Rochester, NY
National Provider Identifier
1033504691
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
325747 Issued in NY
Practice address
601 Elmwood Ave Box 648
Rochester, NY 14642-8648
Phone
(585) 784-2985
NPI assigned
Mar 31, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 287001 MA
Student in an Organized Health Care Education/Training Program 390200000X 63661 NY
Vascular & Interventional Radiology Physician 2085R0204X 325747 NY Primary

Addresses

Primary practice location

601 Elmwood Ave Box 648
Rochester, NY 14642-8648

Mailing address

601 Elmwood Ave Box 648
Rochester, NY 14642-8648
Phone (585) 784-2985

Other practice location 1

47 New Scotland Ave
Department of Internal Medicine
Albany, NY 12208-3412
Phone (518) 262-5377

Other practice location 2

736 Cambridge St
Brighton, MA 02135-2907
Phone (617) 789-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210603003255 MA Practitioner - Diagnostic Radiology 3375838824 Reassigns benefits to 1 organization
I20240328000115 NY Practitioner - Interventional Radiology 3375838824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Radiologists of Univ of RochesterGroup PAC ID 6800700170, 140 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0002
Phone (585) 275-2734

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
287001MAMDVascular & Interventional Radiology Physician
63661NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Radiologists of Univ of Rochester CurrentSince Apr 1, 2024 Accepting new patients
Steward Medical Group, Inc CurrentSince Jul 22, 2023 Accepting new patients

Locations

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

601 Elmwood Ave
#648
Rochester, NY 14642
Phone (585) 275-1376

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Interoperability endpoints

  • Direct secure messaging: mwang107258@direct.urmc.rochester.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1033504691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 648",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146428648",
            "telephone_number": "585-784-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 648",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146428648",
            "telephone_number": "585-784-2985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 New Scotland Ave",
            "address_2": "Department of Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083412",
            "country_code": "US",
            "telephone_number": "518-262-5377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "736 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021352907",
            "country_code": "US",
            "telephone_number": "617-789-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "MATTHEW",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-31",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MA",
            "license": "287001",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "63661",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "325747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.