NPIMap

Individual provider Active NPI

Shihuan Keisin Wang, MD

  • Vascular Surgery Physician
  • Houston, TX
National Provider Identifier
1508285784
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
T1253 Issued in TX
Practice address
1631 North Loop W Ste 610
Houston, TX 77008-1552
Phone
(317) 800-9790
Fax
(713) 880-8374
NPI assigned
Apr 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X T1253 TX Primary

Addresses

Primary practice location

1631 North Loop W Ste 610
Houston, TX 77008-1552

Mailing address

1631 North Loop W Ste 610
Houston, TX 77008-1552

Other practice location 1

1515 Holcombe Blvd
Houston, TX 77030-4000
Phone (713) 792-6161

Other identifiers 2

IdentifierTypeStateIssuer
429663403MedicaidTX
429663404OtherTXCSHCN MEDICAID TPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210727000005 TX Practitioner - Vascular Surgery 8921223637 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Florida College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians
Physicians Referral ServiceGroup PAC ID 7911801410, 2,728 clinicians

Practice addresses (Care Compare)

1445 N Loop W
Suite 720
Houston, TX 77008-1528
Phone (713) 861-7500

1515 Holcombe Blvd
Houston, TX 77030-4000
Phone (713) 792-2121

1631 N Loop
Suite 300
Houston, TX 77008-1528
Phone (713) 343-1080

6400 Fannin St
Suite 2700
Houston, TX 77030-1539
Phone (713) 486-5000

6410 Fannin St
Houston, TX 77030-3005

6411 Fannin St
Houston, TX 77030-1501
Phone (713) 704-0093

6431 Fannin St
MSB2.100
Houston, TX 77030-1501
Phone (713) 500-7700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.29 of 100Reported as group
Quality
70.82
Promoting interoperability
100
Improvement activities
40
Cost
67.65

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T1253TXMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Sep 1, 2021 Accepting new patients
Ut Physicians CurrentSince Sep 1, 2021 Accepting new patients
Physicians Referral Service CurrentSince Sep 23, 2021 Accepting new patients
Memorial Hermann Health System Past Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

1515 Holcombe Blvd
#M
Houston, TX 77030
Phone (713) 792-6127

1631 North Loop W
Ste 610
Houston, TX 77008
Phone (713) 486-0800

1515 Holcombe Blvd
#R4212
Houston, TX 77030
Phone (713) 794-5446

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

Interoperability endpoints

  • Direct secure messaging: swang1@direct.iuhealth.org

Organizations & group practices 5

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 9

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1508285784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 NORTH LOOP W STE 610",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 NORTH LOOP W STE 610",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081552",
            "telephone_number": "317-800-9790",
            "fax_number": "713-880-8374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 Holcombe Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770304000",
            "country_code": "US",
            "telephone_number": "713-792-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "SHIHUAN",
        "middle_name": "KEISIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "T1253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "429663403",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN MEDICAID TPI",
            "identifier": "429663404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.