NPIMap

Individual provider Active NPI

Grace Jen Wang, MD

  • Vascular Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1326029513
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD431585 Issued in PA
Practice address
51 N 39TH St
Philadelphia, PA 19104-2640
Phone
(215) 615-4949
Fax
(215) 243-4649
NPI assigned
Nov 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD431585 PA
Vascular Surgery Physician 2086S0129X MD431585 PA Primary

Addresses

Primary practice location

51 N 39TH St
Philadelphia, PA 19104-2640

Mailing address

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 615-4949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20090707000429 PA Practitioner - Vascular SurgeryPractitioner - General Surgery 3678624483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
New York University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 615-4949

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.47 of 100Reported as individual
Quality
100
Improvement activities
0
Cost
88.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)43
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD431585PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group Vascular Surgery CurrentSince May 1, 2015 Accepting new patients
University of Penn - Medical Group Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

Locations

3400 Spruce St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-2050

501 S 54th St
Philadelphia, PA 19143
Phone (215) 581-2046

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

145 King of Prussia Rd
Ste 110
Wayne, PA 19087
Phone (610) 902-2273

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.

Hospital & facility affiliations 8

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1326029513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-615-4949",
            "fax_number": "215-243-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-615-4949",
            "fax_number": "215-243-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "GRACE",
        "middle_name": "JEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD431585",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD431585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.