Active NPI
Fangda Jiang, MD
- Hospitalist Physician
- Fond Du Lac, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 84732
- Practice address
- 210 Wisconsin American Dr
Fond Du Lac, WI 54937-2999 - Phone
- (920) 907-7500
- NPI assigned
- Jun 5, 2020
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | PT20162 | ND | |
| Student in an Organized Health Care Education/Training Program | 390200000X | MT221145 | PA | |
| Family Medicine Physician | 207Q00000X | 84732 | WI | |
| Hospitalist Physician | 208M00000X | 84732 | WI | Primary |
Addresses
Primary practice location
210 Wisconsin American Dr
Fond Du Lac, WI 54937-2999
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other practice location 1
2550 Mosside Blvd Ste 500
Monroeville, PA 15146-3514
Phone (412) 457-1050
Other practice location 2
900 E Broadway Ave
Bismarck, ND 58501-4520
Phone (701) 530-7000
Other practice location 3
320 E North Ave
Pittsburgh, PA 15212-4756
Phone (412) 359-3541
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100297012 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | fjiang414639@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- University of Utah School of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
210 Wisconsin American Dr
Fond Du Lac, WI 54937-2999
Phone (920) 907-4800
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT20162 | ND | MD | Family Medicine Physician |
| MT221145 | PA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| St. Alexius Medical Center | Current | Accepting new patients | |
| St Alexius Medical Center | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
Locations
900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300
210 Wisconsin American Dr
Fond du Lac, WI 54937
Phone (920) 907-7000
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
Interoperability endpoints
- fjiang414639@direct.myadvocateaurora.org
Organizations & group practices 5
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.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
Family Medicine
-
- Specialist
- Bismarck, ND
- NPI 1205868429
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1659599157
-
- Home Infusion Therapy Pharmacy
- Bismarck, ND
- NPI 1063663607
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Oshkosh, WI
- NPI 1275578064
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738022400000",
"number": "1255955159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "800-326-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 WISCONSIN AMERICAN DR",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549372999",
"telephone_number": "920-907-7500"
}
],
"practiceLocations": [
{
"address_1": "2550 Mosside Blvd Ste 500",
"address_purpose": "LOCATION",
"city": "Monroeville",
"state": "PA",
"postal_code": "151463514",
"country_code": "US",
"telephone_number": "412-457-1050",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "900 E Broadway Ave",
"address_purpose": "LOCATION",
"city": "Bismarck",
"state": "ND",
"postal_code": "585014520",
"country_code": "US",
"telephone_number": "701-530-7000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "320 E North Ave",
"address_purpose": "LOCATION",
"city": "Pittsburgh",
"state": "PA",
"postal_code": "152124756",
"country_code": "US",
"telephone_number": "412-359-3541",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JIANG",
"first_name": "FANGDA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-05",
"last_updated": "2025-01-28",
"certification_date": "2025-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ND",
"license": "PT20162",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PA",
"license": "MT221145",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "84732",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "WI",
"license": "84732",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100297012",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "fjiang414639@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "210 Wisconsin American Dr",
"city": "Fond Du Lac",
"state": "WI",
"country_code": "US",
"postal_code": "549372999",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "210 Wisconsin American Dr",
"city": "Fond Du Lac",
"state": "WI",
"country_code": "US",
"postal_code": "549372999",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fond Du Lac, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.