Individual provider Active NPI

Jingxin Wang, MD

  • Neurocritical Care Physician
  • Greenville, SC
National Provider Identifier
1336501741
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurocritical Care PhysicianTaxonomy code 2084A2900X
License
88355 Issued in SC
Practice address
200 Patewood Dr Ste B350
Greenville, SC 29615-6337
Phone
(864) 454-4500
Fax
(864) 454-4505
NPI assigned
Mar 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neurocritical Care Physician 2084A2900X 71175 CT
Neurocritical Care Physician 2084A2900X 88355 SC Primary
Neurocritical Care Physician 2084A2900X 303280 NY
Neurocritical Care Physician 2084A2900X MC-1554 ID
Neurology Physician 2084N0400X A184314 CA

Addresses

Primary practice location

200 Patewood Dr Ste B350
Greenville, SC 29615-6337

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

9850 W St Lukes Dr
Nampa, ID 83687-7912
Phone (208) 505-2050

Other practice location 2

1303 E Herndon Ave
Fresno, CA 93720-3309
Phone (559) 450-3000

Other practice location 3

100 Nicolls Rd Rm 80
Stony Brook, NY 11794-8122
Phone (631) 444-1116

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY, OR, ID, CO, CA6 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20220614001677 CT Practitioner - NeurologyPractitioner - Psychiatry 7416336979 Reassigns benefits to 4 organizations
I20220803002759 NY Practitioner - Critical Care (Intensivists)Practitioner - Neurology 7416336979 Reassigns benefits to 3 organizations
I20230111001327 OR Practitioner - Neurology 7416336979 Reassigns benefits to 2 organizations
I20230111002944 ID Practitioner - Neurology 7416336979 Reassigns benefits to 1 organization
I20230707000379 CO Practitioner - Neurology 7416336979 Reassigns benefits to 1 organization
I20260618001668 CA Practitioner - Neurology 7416336979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Neurology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians
Blue Sky Telehealth LLCGroup PAC ID 5395155964, 71 clinicians
Midstate Medical CenterGroup PAC ID 7416840699, 187 clinicians

Practice addresses (Care Compare)

1 Lauterbur Dr
Stony Brook Cancer Center
Stony Brook, NY 11794-0001
Phone (631) 444-1213

100 Grand St
New Britain, CT 06052-2016
Phone (860) 224-5121

100 Nicolls Rd
Stony Brook, NY 11794-8122
Phone (631) 444-1213

101 Nicolls Rd
Stony Brook, NY 11794-8122
Phone (631) 444-1213

2825 E Barnett Rd
Medford, OR 97504-8332
Phone (541) 789-7000

30 Eagle Chase
Woodbury, NY 11797-2911
Phone (385) 286-4862

435 Lewis Ave
Meriden, CT 06451-2101
Phone (203) 694-8200

5600 S Quebec St
Suite 312a
Greenwood Village, CO 80111-2208
Phone (303) 343-6272

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • Midstate Medical Center Hospital, Meriden, CT, CCN 070017
  • Shasta Regional Medical Center Hospital, Redding, CA, CCN 050764
  • Centinela Hospital Medical Center Hospital, Inglewood, CA, CCN 050739

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71175CTMDNeurocritical Care Physician
MC-1554IDMDNeurocritical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midstate Medical Center CurrentSince Jun 1, 2022 Accepting new patients
Hartford Hospital CurrentSince Apr 1, 2024 Accepting new patients
New York Spine & Brain Surgery, University Faculty Practice Corporatio CurrentSince Aug 1, 2022 Accepting new patients
Hartford Hospital Neurology CurrentSince Apr 1, 2024 Accepting new patients
Midstate Medical Center Current Accepting new patients
Midstate Medical Center CurrentSince Jun 1, 2022 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Jun 1, 2022 Accepting new patients
Asante Physician Partners CurrentSince Nov 22, 2022 Accepting new patients
Sapphire at Gresham Rehab, LLC CurrentSince May 16, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince May 16, 2024 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Neurology CurrentSince Dec 1, 2022 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Jun 1, 2022 Accepting new patients
University Hospital at Stony Brook Past Accepting new patients

Locations

5600 S Quebec St
Ste 312A
Greenwood Village, CO 80111
Phone (303) 343-6272

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

9850 W St Lukes Dr
Nampa, ID 83687
Phone (208) 205-7282

100 Nicolls Rd
Rm 80
Stony Brook, NY 11794
Phone (631) 444-3429

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

625 SW Ramsey Ave
Ste A
Grants Pass, OR 97527
Phone (541) 474-5004

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

Networks

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

Interoperability endpoints

  • Direct secure messaging: jingxin.wang@xdr.hhchealthdirect.org

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 10

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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1336501741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE B350",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156337",
            "telephone_number": "864-454-4500",
            "fax_number": "864-454-4505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9850 W St Lukes Dr",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836877912",
            "country_code": "US",
            "telephone_number": "208-505-2050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1303 E Herndon Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937203309",
            "country_code": "US",
            "telephone_number": "559-450-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Nicolls Rd Rm 80",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117948122",
            "country_code": "US",
            "telephone_number": "631-444-1116",
            "fax_number": "631-444-1535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "JINGXIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "CT",
            "license": "71175",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "SC",
            "license": "88355",
            "primary": true
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "NY",
            "license": "303280",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "ID",
            "license": "MC-1554",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A184314",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.