Individual provider Active NPI

Mingke Wang, M.D.

  • Surgery Physician
  • New York, NY
National Provider Identifier
1548469778
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
244614 Issued in NY
Practice address
139 Centre St Ste 818
New York, NY 10013-4558
Phone
(646) 590-6735
Fax
(646) 590-6737
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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 244614 NY Primary

Addresses

Primary practice location

139 Centre St Ste 818
New York, NY 10013-4558

Mailing address

139 Centre St Ste 818
New York, NY 10013-4558
Phone (646) 590-6735

Other identifiers 1

IdentifierTypeStateIssuer
02978476MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20070917000142 NY Practitioner - General Surgery 2365536778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
State University of New York Downstate Medical Center, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

139 Centre St
Suite 818
New York, NY 10013-4558
Phone (646) 590-6735

Hospital & facility affiliations

  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
244614NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
MW Surgery, PC Surgery CurrentSince Jan 1, 2021 Accepting new patients

Locations

139 Centre St
Ste 818
New York, NY 10013
Phone (212) 431-4200

139 Centre St
Ph 102
New York, NY 10013
Phone (212) 226-6780

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JACDCD/Endpoint/JACDCD
  • Direct secure messaging: mingkewang@mai.allscriptsdirect.net
  • Direct secure messaging: mwang65664@northwell.direct-ci.com

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.

Hospital & facility affiliations 1

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1548469778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 CENTRE ST STE 818",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134558",
            "telephone_number": "646-590-6735",
            "fax_number": "646-590-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 CENTRE ST STE 818",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134558",
            "telephone_number": "646-590-6735",
            "fax_number": "646-590-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "MINGKE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "244614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02978476",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.