Active NPI
Frederick Mark Wang, M.D.
- Ophthalmology Physician
- New York, NY
National Provider Identifier
1437239761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 118515
- Practice address
- 30 E 40TH St
Suite 405
New York, NY 10016-1201 - Phone
- (212) 684-3980
- Fax
- (212) 684-0838
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 118515 | NY | Primary |
Addresses
Primary practice location
30 E 40TH St
Suite 405
New York, NY 10016-1201
Mailing address
30 East 40TH Street
New York, NY 10016
Phone (212) 684-3980
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110221000701 | NY | Practitioner - Ophthalmology | 7618158874 | Practice locations: New York, NY; Scarsdale, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437239761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 EAST 40TH STREET",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10016",
"telephone_number": "212-684-3980",
"fax_number": "212-684-0838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 E 40TH ST",
"address_2": "SUITE 405",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100161201",
"telephone_number": "212-684-3980",
"fax_number": "212-684-0838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "FREDERICK",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NY",
"license": "118515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.