NPIMap

Individual provider Active NPI

Bo Wang, MD

  • Internal Medicine Physician
  • Frisco, TX
National Provider Identifier
1386643260
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K6949 Issued in TX
Practice address
4525 Ohio Drive
Frisco, TX 75035
Phone
(972) 731-7717
Fax
(972) 731-7733
NPI assigned
Jul 21, 2005
Last updated
Mar 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K6949 TX Primary

Addresses

Primary practice location

4525 Ohio Drive
Frisco, TX 75035

Mailing address

4525 Ohio Drive
Frisco, TX 75035
Phone (972) 731-7717

Other identifiers 1

IdentifierTypeStateIssuer
092558809MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040805000605 TX Practitioner - Internal Medicine 5799755120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
May accept Medicare assignment
Group practices
Frisco Primary Care, PAGroup PAC ID 7517030448, 5 clinicians

Practice addresses (Care Compare)

4525 Ohio Dr
Suite 100
Frisco, TX 75035-5990
Phone (972) 731-7717

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K6949TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frisco Primary Care, P.a. Internal Medicine CurrentSince May 1, 2008 Accepting new patients
The Suchowiecky Center Past Accepting new patients
Inpatient Physician Associates PLLC Internal Medicine Past Accepting new patients
Suncoast Medical Group Inc Past Accepting new patients
Diagnostic Associates of North Texas PA Internal Medicine Past Accepting new patients
Southwest Doctors PA Past Accepting new patients
Dr Beth Yu, M.D.,P.a. Internal Medicine Past Accepting new patients

Locations

4525 Ohio Dr
Frisco, TX 75035
Phone (972) 731-7717

4525 Ohio Dr
Ste 100
Frisco, TX 75035
Phone (972) 731-7717

Interoperability endpoints

  • Direct secure messaging: bo.wang@friscoprimarycare.eclinicaldirectplus.com
  • Direct secure messaging: bwang459816@direct.sw.org
  • FHIR API: https://api.platform.athenahealth.com/4066/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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 3

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1386643260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 OHIO DRIVE",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75035",
            "telephone_number": "972-731-7717",
            "fax_number": "972-731-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 OHIO DRIVE",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75035",
            "telephone_number": "972-731-7717",
            "fax_number": "972-731-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "BO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K6949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092558809",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.