Individual provider Active NPI

Sijia Wang

  • Physician Assistant
  • Elmont, NY
National Provider Identifier
1699484097
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
029321 Issued in NY
Practice address
1307 L St
Elmont, NY 11003-4743
Phone
(347) 879-9508
NPI assigned
Nov 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 029321 NY Primary

Addresses

Primary practice location

1307 L St
Elmont, NY 11003-4743

Mailing address

1307 L St
Elmont, NY 11003-4743
Phone (347) 879-9508

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240419000376 NY Practitioner - Physician Assistant 9133568413 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
029321NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Mar 12, 2024 Accepting new patients

Locations

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: swang1167145@nychhc.direct-ci.com
  • Direct secure messaging: sijiawang@nslijmedgr.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1699484097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 L ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034743",
            "telephone_number": "347-879-9508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 L ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034743",
            "telephone_number": "347-879-9508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "SIJIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "029321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmont, NY

Sources for this page

Verify at the official NPI Registry.