Individual provider Active NPI

Alvin N Wang, DO

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1154576841
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS015076 Issued in PA
Practice address
10800 Knights Rd
Philadelphia, PA 19114-4200
Phone
(215) 612-4963
NPI assigned
Nov 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OT12242 PA
Emergency Medicine Physician 207P00000X OS015076 PA Primary

Addresses

Primary practice location

10800 Knights Rd
Philadelphia, PA 19114-4200

Mailing address

135 Fairview Rd
Penn Valley, PA 19072-1330
Phone (215) 688-8284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100910000244 PA Practitioner - Emergency Medicine 0941325294 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS015076PAMDEmergency Medicine Physician
OT12242PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Aria Health Physician Services CurrentSince Jul 1, 2017 Accepting new patients
University of Penn-Medical Group Emergency Medicine CurrentSince May 1, 2015 Accepting new patients
Aria Health Physician Services Current Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Jul 9, 2019 Accepting new patients
Jefferson Acute Care Physicians, PC CurrentSince Jul 9, 2019 Accepting new patients
Aria Health Physician Services CurrentSince Jul 1, 2017 Accepting new patients
Jefferson Acute Care Physicians, PC Current Accepting new patients

Locations

2966 Street Rd
Bensalem, PA 19020
Phone (215) 638-0666

10800 Knights Rd
Philadelphia, PA 19114
Phone (215) 612-2610

5000 Frankford Ave
Ste 1B
Philadelphia, PA 19124
Phone (215) 583-2355

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3998 Red Lion Rd
Philadelphia, PA 19114
Phone (215) 612-4060

2451 Grant Ave
Philadelphia, PA 19114
Phone (215) 464-8050

Organizations & group practices 9

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": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1154576841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 FAIRVIEW RD",
            "city": "PENN VALLEY",
            "state": "PA",
            "postal_code": "190721330",
            "telephone_number": "215-688-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-612-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "ALVIN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-21",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT12242",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS015076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.