Individual provider Active NPI

Christopher Mark Wang, MD

  • Family Medicine Physician
  • Bronx, NY
National Provider Identifier
1154333276
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
147558 Issued in NY
Practice address
545 E 142ND St
Bronx, NY 10454-2110
Phone
(718) 579-1721
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 147558 NY Primary

Addresses

Primary practice location

545 E 142ND St
Bronx, NY 10454-2110

Mailing address

23 Water Grant St
Apt 11H
Yonkers, NY 10701-3582

Other identifiers 1

IdentifierTypeStateIssuer
00473029MedicaidNY

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
I20070130000100 NY Practitioner - Family Practice 9436150703 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Family Medicine CurrentSince Oct 21, 2019 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Mar 22, 2016 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Trustees of Columbia University in the City of New York Family Medicine CurrentSince Mar 22, 2016 Accepting new patients
The New York and Presbyterian Hospital Family Medicine Past Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients

Locations

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

635 W 165th St
New York, NY 10032
Phone (212) 305-3039

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

610 W 158th St
New York, NY 10032
Phone (212) 544-1860

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 6

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1154333276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 WATER GRANT ST",
            "address_2": "APT 11H",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107013582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 E 142ND ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104542110",
            "telephone_number": "718-579-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "CHRISTOPHER",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "147558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00473029",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.