NPIMap

Individual provider Active NPI

Wei Han Fang, MD

  • Diagnostic Radiology Physician
  • Baltimore, MD
National Provider Identifier
1700090396
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D0074627 Issued in MD
Practice address
22 S Greene St, Dept of Radiology
Baltimore, MD 21201-1544
Phone
(410) 328-3477
NPI assigned
May 10, 2007
Last updated
Nov 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD205374 OR
Diagnostic Radiology Physician 2085R0202X D0074627 MD Primary

Addresses

Primary practice location

22 S Greene St, Dept of Radiology
Baltimore, MD 21201-1544

Mailing address

22 S Greene St, Dept of Radiology
Baltimore, MD 21201-1544
Phone (410) 328-3477

Other practice location 1

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 418-0990

Other practice location 2

335 SE 8th Ave
Hillsboro, OR 97123-4246
Phone (503) 681-1100

Other identifiers 3

IdentifierTypeStateIssuer
058630700MedicaidMD
019522109MedicaidDC
500800559MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, OR3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20121115000012 MD Practitioner - Diagnostic Radiology 1759482474 Reassigns benefits to 3 organizations
I20181205003196 DC Practitioner - Diagnostic Radiology 1759482474 Reassigns benefits to 1 organization
I20210818001569 OR Practitioner - Diagnostic Radiology 1759482474 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Iowa, RJ & L Carver College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tuality Medical Group LLCGroup PAC ID 7416173414, 289 clinicians

Practice addresses (Care Compare)

335 SE 8TH Ave
Hillsboro, OR 97123-4246
Phone (503) 681-1111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0074627MDMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jan 1, 2022 Accepting new patients
Tuality Medical Group LLC CurrentSince Jan 1, 2022 Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Diagnostic Radiology CurrentSince Oct 1, 2012 Accepting new patients
Ohsu Outpatient Clinical Services LLC CurrentSince Dec 12, 2024 Accepting new patients
University Imaging Center, LLC Diagnostic Radiology CurrentSince Oct 1, 2012 Accepting new patients
University Professional Services CurrentSince Jan 1, 2022 Accepting new patients
Tuality Healthcare Current Accepting new patients
University Professional Services Current Accepting new patients
University of Maryland Diagnostic Radiology, LLC Diagnostic Radiology CurrentSince Jul 8, 2017 Accepting new patients
University of Maryland Diagnostic Radiology, LLC Diagnostic Radiology CurrentSince Jul 8, 2017 Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Diagnostic Radiology CurrentSince Oct 1, 2012 Accepting new patients
Tuality Medical Group LLC CurrentSince Jan 1, 2022 Accepting new patients
University Imaging Center, LLC Diagnostic Radiology CurrentSince Oct 1, 2012 Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

22 S Greene St
Rm N2E23
Baltimore, MD 21201
Phone (410) 328-5656

419 W Redwood St
Baltimore, MD 21201
Phone (410) 328-5196

5 Garrett Ave
La Plata, MD 20646
Phone (301) 609-4000

5 N La Plata Ct
Ste 104
La Plata, MD 20646
Phone (301) 539-0345

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

Interoperability endpoints

  • Direct secure messaging: wfang138649@direct.ohsu.edu
  • Direct secure messaging: wfang55498@direct.umm.edu

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1700090396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST, DEPT OF RADIOLOGY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST, DEPT OF RADIOLOGY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-3477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-418-0990",
            "fax_number": "503-494-4982",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "335 SE 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971234246",
            "country_code": "US",
            "telephone_number": "503-681-1100",
            "fax_number": "503-681-1835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANG",
        "first_name": "WEI HAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD205374",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0074627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058630700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019522109",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500800559",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.