Individual provider Active NPI

Ching-Yi Wu, FNP-BC

  • Family Nurse Practitioner
  • Stony Brook, NY
National Provider Identifier
1548727944
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F343822 Issued in NY
Practice address
101 Nicolls Rd FL 11
Stony Brook, NY 11794-0001
Phone
(631) 444-0650
NPI assigned
Feb 22, 2019
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F343822 NY Primary

Addresses

Primary practice location

101 Nicolls Rd FL 11
Stony Brook, NY 11794-0001

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190529001904 NY Practitioner - Nurse Practitioner 3476896770 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F343822NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Children's Service, University Faculty Practice Corporatio CurrentSince Aug 28, 2024 Accepting new patients

Locations

2701 Sunrise Hwy
Islip Terrace, NY 11752
Phone (631) 444-6300

101 Nicolls Rd
Fl 11
Stony Brook, NY 11794
Phone (516) 547-0275

Networks

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1548727944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD FL 11",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "CHING-YI",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-22",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F343822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.