NPIMap

Individual provider Active NPI

Ralph Wang, MD

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
National Provider Identifier
1679744833
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4301117210 Issued in MI
Practice address
235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone
(616) 840-8005
Fax
(616) 840-9642
NPI assigned
Mar 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301117210 MI Primary
Physical Medicine & Rehabilitation Physician 208100000X BP10023392 TX
Physical Medicine & Rehabilitation Physician 208100000X 036120935 IL

Addresses

Primary practice location

235 Wealthy St SE
Grand Rapids, MI 49503-5247

Mailing address

2180 West Manchester Rd
Wheaton, IL 60187
Phone (708) 567-4538

Other identifiers 1

IdentifierTypeStateIssuer
036120935-1MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rwang90361@direct.covenanthealthcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190606002111 MI Practitioner - Physical Medicine and Rehabilitation 8527129386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Free Bed Rehabilitation Hospital 135 clinicians

Practice addresses (Care Compare)

235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone (616) 242-0422

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059
  • University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236
  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • Mary Free Bed Rehabilitation Hospital Inpatient rehabilitation facility, Grand Rapids, MI, CCN 233026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10023392TXMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Free Bed Sub-Acute Rehabilitation Current Accepting new patients
Mary Free Bed Rehabilitation Hospital Physical Medicine & Rehabilitation CurrentSince May 31, 2019 Accepting new patients
Mary Free Bed Rehabilitation Hospital CurrentSince May 31, 2019 Accepting new patients

Locations

235 Wealthy St SE
Grand Rapids, MI 49503
Phone (616) 242-0422

235 Wealthy St SE
Ste 100
Grand Rapids, MI 49503
Phone (616) 493-9724

Interoperability endpoints

  • Direct secure messaging: rwang4540494@direct.trinity-health.org
  • Direct secure messaging: rwang731802@direct.hfhs.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mary Free Bed Sub-Acute RehabilitationGrand Rapids, MI, CCN 235708 Skilled nursing facility Corporate Officer
Corporate Director		 Dec 1, 2022
Dec 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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 6

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": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1679744833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 WEST MANCHESTER RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "60187",
            "telephone_number": "708-567-4538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035247",
            "telephone_number": "616-840-8005",
            "fax_number": "616-840-9642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-17",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301117210",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "BP10023392",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036120935",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036120935-1",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwang90361@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "235 Wealthy St SE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495035247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.