Individual provider Active NPI

Luccie Maning Wo, M.D.

  • Plastic and Reconstructive Surgery Physician
  • New Haven, CT
National Provider Identifier
1518490150
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
21737859 Issued in CT
Practice address
800 Howard Ave FL 4
New Haven, CT 06519-1369
Phone
(203) 785-2570
NPI assigned
Apr 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Plastic and Reconstructive Surgery Physician 2086S0122X 21737859 CT Primary

Addresses

Primary practice location

800 Howard Ave FL 4
New Haven, CT 06519-1369

Mailing address

800 Howard Ave FL 4
New Haven, CT 06519-1369
Phone (203) 785-2570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20241009000110 CT Practitioner - Plastic and Reconstructive Surgery 7113458514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Harvard Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

111 Goose LN
Guilford, CT 06437-5101
Phone (203) 747-7300

1450 Chapel St B
New Haven, CT 06511-4405
Phone 20386754204405

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

5520 Park Ave
Trumbull, CT 06611-3463
Phone (203) 785-4081

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21737859CTMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Sep 3, 2024 Accepting new patients
Yale University CurrentSince Sep 3, 2024 Accepting new patients
Yale University Current Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

800 Howard Ave
Fl 4
New Haven, CT 06519
Phone (203) 785-2593

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 2

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": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1518490150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 HOWARD AVE FL 4",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191369",
            "telephone_number": "203-785-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HOWARD AVE FL 4",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191369",
            "telephone_number": "203-785-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WO",
        "first_name": "LUCCIE",
        "middle_name": "MANING",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CT",
            "license": "21737859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.