Individual provider Active NPI

James Yong Zhen Wu, M.D.

  • Family Medicine Physician
  • Lake Grove, NY
National Provider Identifier
1124117189
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A229361 Issued in NY
Practice address
112 Alexander Ave Unit B
Lake Grove, NY 11755-0429
Phone
(631) 265-8258
Fax
(631) 265-8256
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X A229361 NY
Family Medicine Physician 207Q00000X A229361 NY Primary

Addresses

Primary practice location

112 Alexander Ave Unit B
Lake Grove, NY 11755-0429

Mailing address

112 Alexander Ave Unit B
Lake Grove, NY 11755-0429
Phone (631) 265-8258

Other practice location 1

535 Broadhollow Rd Ste M102
Melville, NY 11747-3719
Phone (631) 249-2481

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040608001187 NY Practitioner - Family Practice 4183607559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

112 Alexander Ave
Unit B
Lake Grove, NY 11755-0429
Phone (631) 265-8258

Merit-based Incentive Payment System (MIPS)

Final score
64.78 of 100Reported as individual
Quality
39.94
Improvement activities
40
Cost
62.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A229361NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew Wu Acupuncture,P.C. Past Accepting new patients

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1124117189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 ALEXANDER AVE UNIT B",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117550429",
            "telephone_number": "631-265-8258",
            "fax_number": "631-265-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 ALEXANDER AVE UNIT B",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117550429",
            "telephone_number": "631-265-8258",
            "fax_number": "631-265-8256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 Broadhollow Rd Ste M102",
            "address_purpose": "LOCATION",
            "city": "Melville",
            "state": "NY",
            "postal_code": "117473719",
            "country_code": "US",
            "telephone_number": "631-249-2481",
            "fax_number": "631-249-2483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WU",
        "first_name": "JAMES",
        "middle_name": "YONG ZHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "A229361",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "A229361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Grove, NY

Sources for this page

Verify at the official NPI Registry.