Individual provider Active NPI

Jimmy Wenje Wang, M.D.

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1205922689
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
230424 Issued in MA
Practice address
88 E Newton St
Boston, MA 02118-2308
Phone
(617) 638-6610
Fax
(617) 638-6616
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 230424 MA
Diagnostic Radiology Physician 2085R0202X 230424 MA Primary

Addresses

Primary practice location

88 E Newton St
Boston, MA 02118-2308

Mailing address

720 Harrison Ave
Dob 503
Boston, MA 02118-2371

Other identifiers 1

IdentifierTypeStateIssuer
110075214AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20221230002211 HI Practitioner - Diagnostic Radiology 6305846882 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1215 Hunakai St
Honolulu, HI 96816-4661
Phone (808) 691-8200

1301 Punchbowl St
Honolulu, HI 96813-2499

1380 Lusitana St
Honolulu, HI 96813-2448

1401 S Beretania St
Suite 750
Honolulu, HI 96814-1881
Phone (808) 691-8526

449 Kapahulu Ave
Suite 104
Honolulu, HI 96815-3850
Phone (808) 735-0007

67-1125 Mamalaho Hwy
Kamuela, HI 96743-8496
Phone (808) 881-4400

91 -2127 Fort Weaver Rd
Ewa Beach, HI 96706-1993
Phone (808) 691-3000

91 -6390 Kapolei Pkwy
Ewa Beach, HI 96706-6380
Phone (808) 735-0007

94 -1144 Ka Uka Blvd
Suite 7
Waipahu, HI 96797-4483
Phone (808) 686-4010

98-199 Kamehameha Hwy
BLDG F
Aiea, HI 96701-4821
Phone (808) 735-0007

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Queens North Hawaii Community Hospital CurrentSince Jul 1, 2023 Accepting new patients
Queens University Medical Group CurrentSince Jul 1, 2023 Accepting new patients
Queens North Hawaii Community Hospital CurrentSince Jul 1, 2023 Accepting new patients
Radiology Associates, Inc Diagnostic Radiology CurrentSince Feb 1, 2023 Accepting new patients

Locations

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

1380 Lusitana St
Ste 1007A
Honolulu, HI 96813
Phone (716) 725-3116

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1205922689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 E NEWTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182308",
            "telephone_number": "617-638-6610",
            "fax_number": "617-638-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "JIMMY",
        "middle_name": "WENJE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MA",
            "license": "230424",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "230424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110075214A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.