Individual provider Active NPI

Donghua Wang, PA-C

  • Surgical Physician Assistant
  • Bel Air, MD
National Provider Identifier
1104065473
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C0003823 Issued in MD
Practice address
510 Upper Chesapeake Dr
Suite 417
Bel Air, MD 21014-4328
Phone
(443) 643-3130
Fax
(443) 643-3133
NPI assigned
Feb 11, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X C0003823 MD Primary

Addresses

Primary practice location

510 Upper Chesapeake Dr
Suite 417
Bel Air, MD 21014-4328

Mailing address

9830 Kraft Hill Rd
Perry Hall, MD 21128-9305
Phone (443) 762-9262

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100310000184 MD Practitioner - Physician Assistant 2264581693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upper Chesapeake Orthopedics, LLC 11 clinicians

Practice addresses (Care Compare)

510 Upper Chesapeake Dr
Suite 417
Bel Air, MD 21014-4336
Phone (443) 643-3130

Hospital & facility affiliations

  • Umd Upper Chesapeake Medical Center Hospital, Bel Air, MD, CCN 210049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0003823MDMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Chesapeake Orthopedics, LLC CurrentSince Feb 20, 2012 Accepting new patients
Upper Chesapeake Surgical Associates, LLC Past Accepting new patients

Locations

650 McHenry Rd
Ste 1200
Aberdeen, MD 21001
Phone (443) 643-3130

510 Upper Chesapeake Dr
Ste 417
Bel Air, MD 21014
Phone (443) 643-3130

515 S Tollgate Rd
Ste 200
Bel Air, MD 21014
Phone (443) 643-3130

515 S Tollgate Rd
Ste 100
Bel Air, MD 21014
Phone (443) 643-3050

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.

Hospital & facility affiliations 1

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": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1104065473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9830 KRAFT HILL RD",
            "city": "PERRY HALL",
            "state": "MD",
            "postal_code": "211289305",
            "telephone_number": "443-762-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 UPPER CHESAPEAKE DR",
            "address_2": "SUITE 417",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144328",
            "telephone_number": "443-643-3130",
            "fax_number": "443-643-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "DONGHUA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-11",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0003823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.