Individual provider Active NPI

Vickie Wu, MD

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1245735505
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2256148 Issued in NY
Practice address
1245 Park Ave
New York, NY 10128-1735
Phone
(212) 427-0540
Fax
(212) 534-1086
NPI assigned
Mar 28, 2018
Last updated
Sep 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2256148 NY Primary

Addresses

Primary practice location

1245 Park Ave
New York, NY 10128-1735

Mailing address

1245 Park Ave
New York, NY 10128-1735
Phone (212) 427-0540

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
I20190107000537 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7416293824

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2256148NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Uptown Pediatrics Pediatrics PastSince Sep 8, 2024 Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1245735505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281735",
            "telephone_number": "212-427-0540",
            "fax_number": "212-534-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281735",
            "telephone_number": "212-427-0540",
            "fax_number": "212-534-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "VICKIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "2256148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.