Active NPI
Randy Wang, DO
- Family Medicine Physician
- Seattle, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OP60408313
- Practice address
- 1660 S Columbian Way
BLDG 1 Room 113
Seattle, WA 98108-1532 - Phone
- (206) 277-5158
- NPI assigned
- Jun 7, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OP60408313 | WA | Primary |
Addresses
Primary practice location
1660 S Columbian Way
BLDG 1 Room 113
Seattle, WA 98108-1532
Mailing address
1660 S Columbian Way
BLDG 1 Room 113
Seattle, WA 98108-1532
Phone (206) 277-5158
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184918112 | Medicaid | WA |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rwang1364998@wm.providencedirect.org | ||
| Direct Messaging Address | rwang1364998@wm.providencedirect.org | ||
| Direct Messaging Address | medicalrecords.healthpoint.p3@direct.hpc.nextgenshare.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP60408313 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neighborcare Health | Current | Accepting new patients | |
| Neighborcare Health | Current | Accepting new patients | |
| Neighborcare Health | Current | Accepting new patients | |
| Neighborcare Health | Current | Accepting new patients |
Locations
9245 Rainier Ave S
Seattle, WA 98118
Phone (206) 461-6981
12721 30th Ave NE
Ste 101
Seattle, WA 98125
Phone (206) 417-0326
6020 35th Ave SW
Seattle, WA 98126
Phone (206) 461-6950
1930 Post Aly
Seattle, WA 98101
Phone (206) 728-4143
1200 12th Ave S
Ste 901
Seattle, WA 98144
Phone (206) 548-3058
4400 37th Ave S
Seattle, WA 98118
Phone (206) 296-4650
1629 N 45th St
Seattle, WA 98103
Phone (206) 633-3350
Interoperability endpoints
- rwang1364998@wm.providencedirect.org
Organizations & group practices 4
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.
-
- Federally Qualified Health Center (FQHC)
- Seattle, WA
- NPI 1578593562
-
- Federally Qualified Health Center (FQHC)
- Seattle, WA
- NPI 1275187429
-
- Federally Qualified Health Center (FQHC)
- Seattle, WA
- NPI 1275567539
-
- Federally Qualified Health Center (FQHC)
- Seattle, WA
- NPI 1871523811
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683590400000",
"number": "1184918112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1660 S COLUMBIAN WAY",
"address_2": "BLDG 1 ROOM 113",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981081532",
"telephone_number": "206-277-5158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1660 S COLUMBIAN WAY",
"address_2": "BLDG 1 ROOM 113",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981081532",
"telephone_number": "206-277-5158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "RANDY",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-07",
"last_updated": "2023-05-09",
"certification_date": "2023-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "OP60408313",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1184918112",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rwang1364998@wm.providencedirect.org",
"affiliation": "N",
"address_1": "217 Broadway E",
"city": "Seattle",
"state": "WA",
"country_code": "US",
"postal_code": "981025723",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rwang1364998@wm.providencedirect.org",
"affiliation": "N",
"address_1": "37624 SE Fury St Ste 101",
"city": "Snoqualmie",
"state": "WA",
"country_code": "US",
"postal_code": "980659680",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "medicalrecords.healthpoint.p3@direct.hpc.nextgenshare.com",
"affiliation": "N",
"address_1": "26401 Pacific Hwy S Ste 101",
"city": "Des Moines",
"state": "WA",
"country_code": "US",
"postal_code": "981989247",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.