Individual provider Active NPI

Hayoung Kim Wang, DO

  • Student in an Organized Health Care Education/Training Program
  • Bayonne, NJ
National Provider Identifier
1417468356
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
29 E 29TH St
Bayonne, NJ 07002-4654
Phone
(201) 858-5249
NPI assigned
Oct 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

29 E 29TH St
Bayonne, NJ 07002-4654

Mailing address

29 E 29TH St
Bayonne, NJ 07002-4654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180129000484 NE Practitioner - Physician Assistant 7719247444 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Physician Assistant

State licenses

LicenseStateTypeSpecialty
2180NEMDProfessional Counselor

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1417468356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 E 29TH ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 E 29TH ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024654",
            "telephone_number": "201-858-5249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "HAYOUNG",
        "middle_name": "KIM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-18",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

Verify at the official NPI Registry.