Organization Active NPI

Yuancong Wang DO PLLC

  • Primary Care Clinic/Center
  • Flushing, NY
National Provider Identifier
1447542600
Registry record updated May 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
229200 Issued in NY
Legal business name
YUANCONG WANG DO PLLC
Practice address
4373 Union St
Suite C-B
Flushing, NY 11355-3045
Phone
(718) 886-3877
Fax
(718) 886-3995
NPI assigned
May 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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

Authorized official

Name
Dr. Yuancong Wang, DO
Title
Proprietor
Phone
(718) 886-3877

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 229200 NY Primary

Addresses

Primary practice location

4373 Union St
Suite C-B
Flushing, NY 11355-3045

Mailing address

4373 Union St
Suite C-B
Flushing, NY 11355-3045
Phone (718) 886-3877

Other identifiers 1

IdentifierTypeStateIssuer
02641041MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130729000543 NY Part B Supplier - Clinic/Group Practice 5890936132 Receives reassigned benefits from 1 practitioner
Practice locations: Flushing, NY

National Provider Directory

National Provider Directory
Tax ID family
Vincent Wang Wellness Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4373 Union St
Ste Cb
Flushing, NY 11355
Phone (718) 883-3877

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1447542600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4373 UNION ST",
            "address_2": "SUITE C-B",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553045",
            "telephone_number": "718-886-3877",
            "fax_number": "718-886-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4373 UNION ST",
            "address_2": "SUITE C-B",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553045",
            "telephone_number": "718-886-3877",
            "fax_number": "718-886-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YUANCONG WANG DO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-06",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "YUANCONG",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "718-886-3877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "229200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02641041",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.