Individual provider Active NPI

Shu H Wang, MD

  • Internal Medicine Physician
  • Shirley, NY
National Provider Identifier
1639188857
Registry record updated Nov 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
204394 Issued in NY
Practice address
550 Montauk Hwy
Shirley, NY 11967-2114
Phone
(631) 852-1001
Fax
(631) 852-1122
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 204394 NY Primary

Addresses

Primary practice location

550 Montauk Hwy
Shirley, NY 11967-2114

Mailing address

550 Montauk Hwy
Shirley, NY 11967-2114
Phone (631) 852-1000

Other identifiers 2

IdentifierTypeStateIssuer
110139899OtherRR#
01769988MedicaidNY

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
I20100504000058 NY Practitioner - Internal Medicine 4789712266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York Medical College, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sun River Health Inc.Group PAC ID 6608783568, 246 clinicians

Practice addresses (Care Compare)

1037 Main St
Peekskill, NY 10566-2913
Phone (914) 734-8800

1200 Brown St
Peekskill, NY 10566-2913

3360 Route 343
Amenia, NY 12501-5619
Phone (845) 838-7038

550 Montauk Hwy
Shirley, NY 11967-2114
Phone (631) 490-3040

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204394NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince Nov 3, 2014 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

6 Henry St
Beacon, NY 12508
Phone (845) 831-0400

1200 Brown St
Peekskill, NY 10566
Phone (845) 838-7020

550 Montauk Hwy
Shirley, NY 11967
Phone (631) 852-1000

Networks

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

Interoperability endpoints

  • Direct secure messaging: shu.wang@hrh.eclinicaldirectplus.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257292800000",
    "number": "1639188857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MONTAUK HWY",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672114",
            "telephone_number": "631-852-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MONTAUK HWY",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672114",
            "telephone_number": "631-852-1001",
            "fax_number": "631-852-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "SHU",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2009-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "204394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR#",
            "identifier": "110139899",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01769988",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shirley, NY

Sources for this page

Verify at the official NPI Registry.