Individual provider Active NPI

Dorothy Wan, N.P.

  • Nurse Practitioner
  • Dublin, CA
National Provider Identifier
1306287883
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP842009 Issued in CA
Practice address
4050 Dublin Blvd
Dublin, CA 94568-3112
Phone
(925) 875-6100
NPI assigned
Jul 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 23084 CA
Nurse Practitioner 363L00000X NP842009 CA Primary

Addresses

Primary practice location

4050 Dublin Blvd
Dublin, CA 94568-3112

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (925) 875-6100

Other practice location 1

1569 Sloat Blvd Ste 333
San Francisco, CA 94132-1255
Phone (757) 559-1893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131118001087 CA Practitioner - Nurse Practitioner 0042446247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

3200 Kearney St
Fremont, CA 94538-2299
Phone (510) 490-1222

4050 Dublin Blvd
Dublin, CA 94568-3112
Phone (925) 875-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
23084CAMDDermatology Physician
NP842009CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Aug 7, 2017 Accepting new patients
Asian Health Services CurrentSince Sep 23, 2013 Accepting new patients
Asian Health Services CurrentSince Sep 23, 2013 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Aug 7, 2017 Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients

Locations

4050 Dublin Blvd
Dublin, CA 94568
Phone (925) 875-6100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

818 Webster St
Oakland, CA 94607
Phone (510) 986-6800

101 8th St
Ste 100
Oakland, CA 94607
Phone (510) 735-3100

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: dwan239844@hisp.ehr.sutterhealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1306287883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "925-875-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 DUBLIN BLVD",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945683112",
            "telephone_number": "925-875-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1569 Sloat Blvd Ste 333",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941321255",
            "country_code": "US",
            "telephone_number": "757-559-1893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAN",
        "first_name": "DOROTHY",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "23084",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP842009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, CA

Sources for this page

Verify at the official NPI Registry.