Jin Yuan Wang, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

82010 Issued in WI

Practice address

1650 S 41St St
Manitowoc, WI 54220-7316

Phone

(920) 320-2436

NPI assigned

Mar 25, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Froedtert Manitowoc Medical Group, LLCGroup PAC ID 2365836954, 156 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Froedtert Holy Family Memorial Home Care Home health agency, Manitowoc, WI, CCN 527154
• Holy Family Memorial Hospital, Manitowoc, WI, CCN 520107
• St Marys Home for the Aged Nursing home, Manitowoc, WI, CCN 525609

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwang640959@direct.froedtert.com

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.

• Froedtert Manitowoc Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Manitowoc, WI
  • NPI 1437829975
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holy Family Memorial Inc

  • Home Health Agency
  • Manitowoc, WI
  • NPI 1174629075
  Care Compare affiliation
• Holy Family Memorial Inc

  • General Acute Care Hospital
  • Manitowoc, WI
  • NPI 1700998697
  Care Compare affiliation
• St. Mary'S Home for the Aged, Inc

  • Skilled Nursing Facility
  • Manitowoc, WI
  • NPI 1609882448

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1396372850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 S 41ST ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542207316",
            "telephone_number": "920-320-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 S 41ST ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542207316",
            "telephone_number": "920-320-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "JIN YUAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WI",
            "license": "82010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherie L Wadle, M.S. CCC-SLP
• Tait David Waege, R.PH.
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Crista Ward
• Benjamin J Wass, P.A.
• Shondra T Watson, LPC
• Marianne E Webers, MSW
• Dakota Wehausen

• General Practice Physician in Manitowoc, WI
• Providers in Manitowoc, WI by specialty
• General Practice Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.