Individual provider Active NPI

Ping Y Wang, MD

  • Surgery Physician
  • Peoria, AZ
National Provider Identifier
1548200652
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25546 Issued in AZ
Practice address
13640 N Plaza del Rio Blvd
Ste 310
Peoria, AZ 85381-4846
Phone
(623) 876-3910
Fax
(623) 876-6953
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25546 AZ Primary

Addresses

Primary practice location

13640 N Plaza del Rio Blvd
Ste 310
Peoria, AZ 85381-4846

Mailing address

13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846
Phone (623) 876-3800

Other identifiers 2

IdentifierTypeStateIssuer
434027MedicaidAZ
020037148OtherAZRAILROAD MEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Arizona Medical Clinic LTD Current Accepting new patients
Sun Health MRI Center Past Accepting new patients

Locations

13640 N Plaza del Rio Blvd
Ste 310
Peoria, AZ 85381
Phone (623) 876-3800

13760 N 93rd Ave
Ste 107
Peoria, AZ 85381
Phone (623) 876-3952

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

13640 N Plaza del Rio Blvd
Ste 230
Peoria, AZ 85381
Phone (623) 876-3810

9201 W Thomas Rd
Phoenix, AZ 85037
Phone (623) 327-4000

Organizations & group practices 2

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1548200652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13640 N PLAZA DEL RIO BLVD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814846",
            "telephone_number": "623-876-3800",
            "fax_number": "623-972-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13640 N PLAZA DEL RIO BLVD",
            "address_2": "STE 310",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814846",
            "telephone_number": "623-876-3910",
            "fax_number": "623-876-6953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "PING",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "25546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "434027",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "020037148",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.