Active NPI
Gloria Wang, M.D.
- Pediatrics Physician
- Buffalo, NY
National Provider Identifier
1275568958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 189620
- Practice address
- 1595 Bailey Ave
Buffalo, NY 14212-2008 - Phone
- (716) 893-8550
- Fax
- (716) 893-4020
- NPI assigned
- Jul 11, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 189620 | NY | Primary |
Addresses
Primary practice location
1595 Bailey Ave
Buffalo, NY 14212-2008
Mailing address
1595 Bailey Ave
Buffalo, NY 14212-2008
Phone (716) 893-8550
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00020520303 | Other | NY | UNIVERA |
| 080911000044 | Other | NY | FIDELIS |
| 1206881 | Other | NY | INDEPENDENT HEALTH |
| 000523591006 | Other | NY | BLUE CROSS |
| 000523591005 | Other | NY | BLUE CROSS OF WNY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 189620 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sisters of Charity Hospital of Buffalo New York | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Cheektowaga, NY
- NPI 1043455199
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226620800000",
"number": "1275568958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1595 BAILEY AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142122008",
"telephone_number": "716-893-8550",
"fax_number": "716-893-4020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1595 BAILEY AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142122008",
"telephone_number": "716-893-8550",
"fax_number": "716-893-4020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "GLORIA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2008-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "189620",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA",
"identifier": "00020520303",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS",
"identifier": "080911000044",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENT HEALTH",
"identifier": "1206881",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "000523591006",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF WNY",
"identifier": "000523591005",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.