Active NPI
Derek Zhou Wang, MD
- Pediatric Radiology Physician
- Fargo, ND
National Provider Identifier
1245890342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Radiology Physician
- License
- MT231660
- Practice address
- 5225 23Rd Ave S
Fargo, ND 58104-7927 - Phone
- (701) 417-2575
- NPI assigned
- Jun 19, 2019
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 4351045644 | MI | |
| Pediatric Radiology Physician | 2085P0229X | MT231660 | PA | Primary |
Addresses
Primary practice location
5225 23Rd Ave S
Fargo, ND 58104-7927
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Other practice location 1
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone (267) 590-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250830000065 | ND | Practitioner - Diagnostic Radiology | 1254832231 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Medical Center Fargo
Practice addresses (Care Compare)
5225 23Rd Ave S
Fargo, ND 58104-7927
Phone (701) 417-2575
Hospital & facility affiliations
- Sanford Medical Center Fargo
- Perham Health
- Sanford Thief River Falls Medical Center
- Kittson Healthcare
- Sanford Mayville
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT231660 | PA | MD | Pediatric Radiology Physician |
| 4351045644 | MI | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Current | Accepting new patients | |
| Sanford Medical Center Fargo | Current | Accepting new patients |
Locations
5225 23rd Ave S
Fargo, ND 58104
Phone (701) 234-5933
1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445
Interoperability endpoints
- dwang573785@direct.hfhs.org
Organizations & group practices 3
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.
-
- Rural Health Clinic/Center
- Ellendale, ND
- NPI 1346256682
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1528009412
Hospital & facility affiliations 13
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Multi-Specialty Clinic/Center
- Thief River Falls, MN
- NPI 1861895906
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755475200000",
"number": "1245890342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5074",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5225 23RD AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581047927",
"telephone_number": "701-417-2575"
}
],
"practiceLocations": [
{
"address_1": "3401 Civic Center Blvd",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191044319",
"country_code": "US",
"telephone_number": "267-590-7000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WANG",
"first_name": "DEREK",
"middle_name": "ZHOU",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-19",
"last_updated": "2025-08-18",
"certification_date": "2025-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "4351045644",
"primary": false
},
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "PA",
"license": "MT231660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.