Wayne Sy Fang, MD

Primary specialty

Neuroradiology PhysicianTaxonomy code 2085N0700X

License

MD60082880 Issued in WA

Practice address

19020 33Rd Ave W
Suite 210
Lynnwood, WA 98036-4748

Phone

(425) 563-1500

Fax

(425) 563-1501

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Optum Care Washington PLLC

  • Durable Medical Equipment & Medical Supplies
  • Marysville, WA
  • NPI 1194428425
  NPD
• Optum Care Washington PLLC

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1831186766
  NPD
• Radia Imaging Center Holdings LLC

  • Diagnostic Radiology Physician
  • Vancouver, WA
  • NPI 1154942886
  NPD
• Radia Imaging Center Holdings LLC

  • Diagnostic Radiology Physician
  • Seattle, WA
  • NPI 1639653017
  NPD
• Radiology Associates PA

  • Diagnostic Radiology Physician
  • Little Rock, AR
  • NPI 1366438186
  NPD
• University Radiology Associates

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1639124498

  Neuroradiology

  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1295810133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W",
            "address_2": "SUITE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANG",
        "first_name": "WAYNE",
        "middle_name": "SY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "46465 - 020",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60082880",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "WA",
            "license": "MD60082880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-SOUTH SOUND RADIOLOGY",
            "identifier": "0385162",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-SWEDISH RADIA EDMONDS",
            "identifier": "0367299",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-EVERGREEN RADIA",
            "identifier": "0367300",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-RADIA REST OF WA",
            "identifier": "0367297",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-RADIA KING COUNTY",
            "identifier": "0367298",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2000900",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eye-Q Vision Care PLLC
• Shahd Fadul
• Saddiq Faizi
• Mariah Falin
• Family First Phlebotomy
• Lisa Fanning, LMP
• Tigist Alemu Fantai, RN
• N Farage, MS, CCC-SLP, CBIS
• Fouzia Hashi Farah
• Ashley M Farrar

• Neuroradiology Physician in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Neuroradiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.