Individual provider Active NPI

Grace Wang, FNP-BC

  • Family Nurse Practitioner
  • Rego Park, NY
National Provider Identifier
1104365303
Registry record updated Aug 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
342655 Issued in NY
Practice address
98120 Queens Blvd Ste 1C
Rego Park, NY 11374-4414
Phone
(347) 436-8335
Fax
(347) 236-3161
NPI assigned
Feb 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 342655 NY Primary

Addresses

Primary practice location

98120 Queens Blvd Ste 1C
Rego Park, NY 11374-4414

Mailing address

17020 Crocheron Ave Apt 106
Flushing, NY 11358-2268
Phone (917) 855-7467

Other practice location 1

6475 Austin St Apt M1
Rego Park, NY 11374-4195
Phone (347) 436-8335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210130000035 NY Practitioner - Nurse Practitioner 6608280839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6475 Austin St
Apt M1
Rego Park, NY 11374-4195
Phone (347) 436-8335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rego Park Family Health NP PC Family Current Accepting new patients
Grace Wang NP in Family Health P.C. Family CurrentSince Jul 3, 2023 Accepting new patients

Locations

98120 Queens Blvd
Ste 1C
Rego Park, NY 11374
Phone (718) 268-9598

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

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.

NPI Registry JSON

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785542400000",
    "number": "1104365303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17020 CROCHERON AVE APT 106",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113582268",
            "telephone_number": "917-855-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98120 QUEENS BLVD STE 1C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744414",
            "telephone_number": "347-436-8335",
            "fax_number": "347-236-3161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6475 Austin St Apt M1",
            "address_purpose": "LOCATION",
            "city": "Rego Park",
            "state": "NY",
            "postal_code": "113744195",
            "country_code": "US",
            "telephone_number": "347-436-8335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "GRACE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-21",
        "last_updated": "2026-08-01",
        "certification_date": "2026-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "342655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.