Individual provider Active NPI

Jing Xing Zhang, M.D.

  • Dermatology Physician
  • Philadelphia, PA
National Provider Identifier
1396006508
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MT201306 Issued in PA
Practice address
219 N Broad St
4TH Floor
Philadelphia, PA 19107-1519
Phone
(215) 762-5557
NPI assigned
Jun 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MT201306 PA Primary

Addresses

Primary practice location

219 N Broad St
4TH Floor
Philadelphia, PA 19107-1519

Mailing address

209 Filbert St
Roselle Park, NJ 07204-2215
Phone (908) 590-6955

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jzhang154625@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150803001275 WI Practitioner - Dermatology 2567776628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

36500 Aurora Dr
Summit, WI 53066-4899
Phone (262) 434-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1330
Removal or shaving of skin growth109
Skin biopsy316

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT201306PAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Aug 24, 2015 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 24, 2015 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

36500 Aurora Dr
Summit, WI 53066
Phone (262) 434-1000

Interoperability endpoints

  • Direct secure messaging: jzhang154625@direct.myadvocateaurora.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1396006508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 FILBERT ST",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072042215",
            "telephone_number": "908-590-6955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N BROAD ST",
            "address_2": "4TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071519",
            "telephone_number": "215-762-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHANG",
        "first_name": "JING",
        "middle_name": "XING",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-04",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MT201306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jzhang154625@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "219 N Broad St",
            "address_2": "4th Floor",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191071519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "219 N Broad St",
            "address_2": "4th Floor",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191071519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.