Angie Yueqi Wan, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

85242-20 Issued in WI

Practice address

10000 W Bluemound Rd
Wauwatosa, WI 53226-4321

Phone

(414) 805-5320

Fax

(414) 805-5320

NPI assigned

Apr 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Dermatology

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awan956110@direct.froedtert.com

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.

• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086

  Dermatology

  Medicare reassignment Care Compare group NPD
• The Medical College of Wisconsin Inc

  • Case Management Agency
  • Milwaukee, WI
  • NPI 1649521105
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Froedtert Memorial Lutheran Hospital, Inc.

  dba CDI-Froedtert Memorial Lutheran Hospital

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1255334173
  Care Compare affiliation

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1649850066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 W BLUEMOUND RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264321",
            "telephone_number": "414-805-5320",
            "fax_number": "414-805-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W BLUEMOUND RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264321",
            "telephone_number": "414-805-5320",
            "fax_number": "414-805-5320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 N 99th St",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532264339",
            "country_code": "US",
            "telephone_number": "414-805-5320 x41480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-5320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAN",
        "first_name": "ANGIE",
        "middle_name": "YUEQI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-09",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "85242-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Patrick Walsh-Rynders
• Austin Thomas Walsh, PA-C
• Christopher John Walsh, MD
• Deontay Walsh
• John Patrick Walsh, MD
• Karolyn A Wanat, MD
• Samantha Wanek, MS, LPC, NCC
• Weili Wang, MD
• Lee S Wann, M.D.
• Warby Parker Inc.

• Dermatology Physician in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Dermatology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.