NPIMap

Individual provider Active NPI

Jennifer Wang, D.O.

  • Surgical Critical Care Physician
  • New York, NY
National Provider Identifier
1306116934
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
275058 Issued in NY
Practice address
One Gustave Levy Place, Department of Surgery
1264
New York, NY 10029
Phone
(212) 241-8867
Fax
(212) 860-3669
NPI assigned
Jan 12, 2012
Last updated
Dec 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 275058 NY
Surgical Critical Care Physician 2086S0102X 275058 NY Primary

Addresses

Primary practice location

One Gustave Levy Place, Department of Surgery
1264
New York, NY 10029

Mailing address

One Gustave Levy Place
1264
New York, NY 10029
Phone (212) 241-8867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170206000166 NY Practitioner - General SurgeryPractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 8527341106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists), Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 241-6500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Critical Care Medicine CurrentSince Apr 7, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 7, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients

Locations

13620 38th Ave
Flushing, NY 11354
Phone (718) 353-7701

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1306116934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE GUSTAVE LEVY PLACE",
            "address_2": "1264",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "212-241-8867",
            "fax_number": "212-860-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE GUSTAVE LEVY PLACE, DEPARTMENT OF SURGERY",
            "address_2": "1264",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "212-241-8867",
            "fax_number": "212-860-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "JENNIFER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-12",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NY",
            "license": "275058",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NY",
            "license": "275058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.