Individual provider Active NPI

Steven Zhixie Wang, M.D.

  • Physical Medicine & Rehabilitation Physician
  • San Jose, CA
National Provider Identifier
1639523616
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A173527 Issued in CA
Practice address
2101 Forest Ave Ste 220a
San Jose, CA 95128-1473
Phone
(408) 295-8628
Fax
(408) 295-8061
NPI assigned
Apr 15, 2016
Last updated
Nov 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Medicine & Rehabilitation Physician 208100000X A173527 CA Primary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X A173527 CA

Addresses

Primary practice location

2101 Forest Ave Ste 220a
San Jose, CA 95128-1473

Mailing address

2101 Forest Ave Ste 220a
San Jose, CA 95128-1473
Phone (408) 295-8628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210830001150 CA Practitioner - Pain Management 4981944675 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
University of Pittsburgh School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Bay Orthopedic and Sports Medicine Clinic, IncGroup PAC ID 6901974351, 3 clinicians

Practice addresses (Care Compare)

333 Oconnor Dr
San Jose, CA 95128-1623
Phone (408) 376-3380

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A173527CAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Bay Orthopedic and Sports Medicine Clinic, Inc. Physical Medicine & Rehabilitation CurrentSince Mar 24, 2024 Accepting new patients
Justin Lo MD a Professional Medical Corporation CurrentSince Sep 1, 2021 Accepting new patients

Locations

221 E Hacienda Ave
Ste D
Campbell, CA 95008
Phone 4083564959200

2101 Forest Ave
Ste 220A
San Jose, CA 95128
Phone (408) 295-8628

333 Oconnor Dr
San Jose, CA 95128
Phone (408) 297-3484

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1639523616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 FOREST AVE STE 220A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281473",
            "telephone_number": "408-295-8628",
            "fax_number": "408-295-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 FOREST AVE STE 220A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281473",
            "telephone_number": "408-295-8628",
            "fax_number": "408-295-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "STEVEN",
        "middle_name": "ZHIXIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-15",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A173527",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A173527",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.