Individual provider Active NPI

Michael Zhaoyu Wang, M.D.

  • Dermatology Physician
  • Rochester, MN
National Provider Identifier
1053744912
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A156280 Issued in CA
Practice address
200 1St St SW
Rochester, MN 55905
Phone
(507) 284-2511
NPI assigned
Aug 14, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57.022590 OH
Dermatology Physician 207N00000X A156280 CA Primary
Dermatology Physician 207N00000X 58486 MN

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905

Mailing address

1701 Divisadero St
San Francisco, CA 94115-3011
Phone (507) 284-2511

Other practice location 1

200 1st St SW
Rochester, MN 55905
Phone (507) 284-2511

Other names 1

  • Zhaoyu Wang Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190524002417 CA Practitioner - DermatologyPractitioner - Other (Physician) 6204053523 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Minnesota Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2255 Ygnacio Valley Rd
Suite B1
Walnut Creek, CA 94598-3335
Phone (925) 945-7005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision191
Removal of skin lesions3060
Removal or shaving of skin growth829
Skin biopsy188

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A156280CAMDDermatology Physician
57.022590OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Dermatology Associates, Inc. CurrentSince Apr 1, 2020 Accepting new patients
Golden State Dermatology Associates, Inc. Dermatology CurrentSince Apr 1, 2020 Accepting new patients
Permanente Medical Group Inc Dermatology CurrentSince Mar 20, 2019 Accepting new patients
Permanente Medical Group, Inc CurrentSince Mar 20, 2019 Accepting new patients
Mayo Clinic Health System-Fairmont Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
Mayo Clinic Health System-Lake City Past Accepting new patients
University of California San Francisco Past Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Past Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

1200 Central Blvd
Ste D
Brentwood, CA 94513
Phone (925) 308-9510

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

99 Montecillo Rd
San Rafael, CA 94903
Phone (415) 444-2047

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

2255 Ygnacio Valley Rd
Ste B1
Walnut Creek, CA 94598
Phone (925) 945-7005

355 Lennon Ln
Ste 255
Walnut Creek, CA 94598
Phone (925) 932-7704

370 N Wiget Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 278-7592

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 9

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": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1053744912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 DIVISADERO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153011",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55905",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "55905",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "MICHAEL",
        "middle_name": "ZHAOYU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-14",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.022590",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A156280",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "58486",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ZHAOYU",
            "last_name": "WANG",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.