Individual provider Active NPI

Yan Wang

  • Dermatology Physician
  • St Louis Park, MN
National Provider Identifier
1699752444
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
48082 Issued in MN
Practice address
3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone
(952) 993-3789
NPI assigned
Dec 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 48082 MN Primary

Addresses

Primary practice location

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527

Mailing address

3800 Park Nicollet Blvd
Credentialing
Minneapolis, MN 55416-2527

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
I20140421000951 CA Practitioner - Dermatology 1254367030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

10670 Wexford St
San Diego, CA 92131-3940
Phone (858) 621-4002

16950 Via Tazon
San Diego, CA 92127-1607
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision49
Removal of skin lesions618
Removal or shaving of skin growth66
Skin biopsy262

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56020CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc Dermatology CurrentSince Mar 16, 2015 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Mar 16, 2015 Accepting new patients
Park Nicollet Methodist Hospital Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

7862 El Cajon Blvd
La Mesa, CA 91942
Phone (619) 644-6401

16899 W Bernardo Dr
San Diego, CA 92127
Phone (858) 499-2705

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

Interoperability endpoints

  • Direct secure messaging: ywang32691@sharphealthcare.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1699752444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD",
            "address_2": "CREDENTIALING",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554162527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527",
            "telephone_number": "952-993-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "YAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "48082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.