Individual provider Active NPI

Grace Yiwen Wang, M.D.

  • Dermatopathology (Pathology) Physician
  • Lambertville, MI
National Provider Identifier
1689094179
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
4301104706 Issued in MI
Practice address
7301 Secor Rd
Lambertville, MI 48144-9737
Phone
(419) 479-5795
Fax
(419) 479-5797
NPI assigned
Apr 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X 4301104706 MI Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 0101266067 VA

Addresses

Primary practice location

7301 Secor Rd
Lambertville, MI 48144-9737

Mailing address

4235 Secor Rd
Toledo, OH 43623-4299
Phone (419) 473-3561

Other practice location 1

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210225001041 MI Practitioner - Pathology 6507166162 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Toledo College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

2800 Plymouth Rd
Ann Arbor, MI 48109-2800
Phone (734) 936-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince May 28, 2024 Accepting new patients
Regents of the University of Michigan Dermatopathology CurrentSince May 28, 2024 Accepting new patients
McLaren Health Management Group Current Accepting new patients
McLaren Health Management Group CurrentSince Dec 1, 2024 Accepting new patients
McLaren Health Management Group Current Accepting new patients

Locations

2800 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 647-2921

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

1515 Cal Dr
Davison, MI 48423
Phone (810) 496-8640

28050 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 471-8000

3270 W Silver Lake Rd
Fenton, MI 48430
Phone (810) 208-7765

4000 S Saginaw St
Flint, MI 48507
Phone (810) 396-5700

Organizations & group practices 5

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 4

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": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1689094179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234299",
            "telephone_number": "419-473-3561",
            "fax_number": "419-479-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 SECOR RD",
            "city": "LAMBERTVILLE",
            "state": "MI",
            "postal_code": "481449737",
            "telephone_number": "419-479-5795",
            "fax_number": "419-479-5797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095000",
            "country_code": "US",
            "telephone_number": "734-936-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "GRACE",
        "middle_name": "YIWEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "MI",
            "license": "4301104706",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0101266067",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lambertville, MI

Sources for this page

Verify at the official NPI Registry.