Active NPI
Jingsong Wang, MD
- Rheumatology Physician
- Philadelphia, PA
National Provider Identifier
1164467494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- MD429692
- Practice address
- 3400 Spruce St
8 Penn Tower
Philadelphia, PA 19104-4206 - Phone
- (215) 662-2789
- Fax
- (215) 662-4500
- NPI assigned
- Jun 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 213783 | MA | |
| Rheumatology Physician | 207RR0500X | MD429692 | PA | Primary |
Addresses
Primary practice location
3400 Spruce St
8 Penn Tower
Philadelphia, PA 19104-4206
Mailing address
664 Thomas Jefferson Rd
Wayne, PA 19087-1034
Phone (484) 865-8363
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 213783 | MA | MD | Rheumatology Physician |
| MD429692 | PA | MD | Rheumatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164467494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "664 THOMAS JEFFERSON RD",
"city": "WAYNE",
"state": "PA",
"postal_code": "190871034",
"telephone_number": "484-865-8363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"address_2": "8 PENN TOWER",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044206",
"telephone_number": "215-662-2789",
"fax_number": "215-662-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "JINGSONG",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "MA",
"license": "213783",
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "PA",
"license": "MD429692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.