Individual provider Active NPI

Xipu Jack Wu, MD

  • Internal Medicine Physician
  • Rowland Heights, CA
National Provider Identifier
1407942634
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A69486 Issued in CA
Practice address
19115 Colima Rd Unit 202
Rowland Heights, CA 91748-3075
Phone
(626) 912-4147
Fax
(626) 912-3326
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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 A69486 CA Primary

Addresses

Primary practice location

19115 Colima Rd Unit 202
Rowland Heights, CA 91748-3075

Mailing address

19115 Colima Rd Unit 202
Rowland Heights, CA 91748-3075
Phone (626) 912-4147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070525000589 CA Practitioner - Internal Medicine 2961509930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19115 Colima Rd
Unit 202
Rowland Heights, CA 91748-3075
Phone (626) 912-4147

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A69486CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jack Wu MD Inc Internal Medicine CurrentSince Mar 5, 2007 Accepting new patients
Wu & Diaz Professional Corp Internal Medicine Past Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients

Locations

4950 San Bernardino St
Ste 102
Montclair, CA 91763
Phone (951) 314-2255

19115 Colima Rd
Unit 202
Rowland Hghts, CA 91748
Phone (626) 912-4147

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1407942634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19115 COLIMA RD UNIT 202",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917483075",
            "telephone_number": "626-912-4147",
            "fax_number": "626-912-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19115 COLIMA RD UNIT 202",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917483075",
            "telephone_number": "626-912-4147",
            "fax_number": "626-912-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "XIPU",
        "middle_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A69486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rowland Heights, CA

Sources for this page

Verify at the official NPI Registry.