Kayllie Wang, MD
Individual provider Active NPI Pediatrics Physician · Upper St Clair, PA
NPI 1033564372 · NPPES record last updated Jan 5, 2023
Key facts
- NPI
- 1033564372
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MD466540 (PA)
- Practice address
- 1580 McLaughlin Run Rd Ste 208
Upper St Clair, PA 15241-3100 - Phone
- (412) 221-2121
- NPI assigned
- Apr 23, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161128002505 | OH | Order and Referring Only - Pediatric Medicine |
2163701640 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD466540 | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Alliance, St. Clair Division | Pediatrics | Past |
Accepting new patients |
| Allegheny Clinic Pediatrics | Pediatrics | Past |
Accepting new patients |
Interoperability endpoints
- kwang238243@direct.ahn.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | MD466540 | PA | Yes |
Addresses
Primary practice location
1580 McLaughlin Run Rd Ste 208
Upper St Clair, PA 15241-3100
Mailing address
1100 Washington Ave Ste 215
Carnegie, PA 15106-3616
Phone (412) 278-3310
Other practice location 1
1200 Brooks Ln Ste 130
Clairton, PA 15025-3749
Phone (412) 460-8111
Other providers in Upper St Clair, PA
- Dennis Peter Tihansky
- Jenna Trinh
- Jeffrey P Verner
- Ryan Charles Vietmeier
- Pamela Volz
- Mark Waters
- Britney Wehrle
- Christina M Welc
- William J Katsur, DMD
- Emily Sue Wockley
All providers in Upper St Clair, PA · Pediatrics Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.