Individual provider Active NPI

Linda C Wang, MD JD

  • Dermatology Physician
  • Lutherville, MD
National Provider Identifier
1063479756
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
D0072992 Issued in MD
Practice address
1205 York Rd Ste 39a
Lutherville, MD 21093-6219
Phone
(443) 288-1870
Fax
(443) 288-6639
NPI assigned
Apr 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X D0072992 MD Primary

Addresses

Primary practice location

1205 York Rd Ste 39a
Lutherville, MD 21093-6219

Mailing address

1205 York Rd Ste 39a
Lutherville, MD 21093-6219
Phone (443) 288-1870

Other practice location 1

1800 Orleans St
Baltimore, MD 21287-0010
Phone (410) 955-8893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20111014000280 MD Practitioner - Dermatology 8022098995 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Chicago, Pritzker School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1205 York Rd
Suite 39a
Lutherville, MD 21093-6219
Phone (443) 288-1870

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision114
Removal of skin lesions2073
Removal or shaving of skin growth82
Skin biopsy175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Juris Doctor, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St. Paul Place Specialists, Inc. Current Accepting new patients
St. Paul Place Specialists, Inc. CurrentSince Sep 21, 2011 Accepting new patients
St Paul Place Specialists Inc CurrentSince Sep 21, 2011 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

Organizations & group practices 5

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1063479756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 YORK RD STE 39A",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936219",
            "telephone_number": "443-288-1870",
            "fax_number": "443-288-6639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 YORK RD STE 39A",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936219",
            "telephone_number": "443-288-1870",
            "fax_number": "443-288-6639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Orleans St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870010",
            "country_code": "US",
            "telephone_number": "410-955-8893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "LINDA",
        "middle_name": "C",
        "credential": "MD JD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0072992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

Verify at the official NPI Registry.