Individual provider Active NPI

Nan Wang

  • Student in an Organized Health Care Education/Training Program
  • Flushing, NY
National Provider Identifier
1700249216
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
14445 Sanford Ave
Apt 4a
Flushing, NY 11355-1679
Phone
(347) 259-3088
NPI assigned
Apr 1, 2016
Last updated
Apr 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

14445 Sanford Ave
Apt 4a
Flushing, NY 11355-1679

Mailing address

14445 Sanford Ave
Apt 4a
Flushing, NY 11355-1679
Phone (347) 259-3088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210604002548 NY Practitioner - Physical Medicine and Rehabilitation 4587063961 Reassigns benefits to 1 organization
I20241217000110 NJ Practitioner - Physical Medicine and Rehabilitation 4587063961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Albert Einstein College of Medicine of Yeshiva University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabilitation Specialists of New Jersey LLCGroup PAC ID 9931197050, 15 clinicians

Practice addresses (Care Compare)

120 Eagle Rock Ave
Suite 154
East Hanover, NJ 07936-3168
Phone (201) 407-5145

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince May 14, 2021 Accepting new patients
Montefiore Medical Center CurrentSince May 14, 2021 Accepting new patients
Rehabilitation Specialists of New Jersey, LLC CurrentSince Oct 1, 2024 Accepting new patients
Montefiore Mount Vernon Hospital Past Accepting new patients

Locations

120 Eagle Rock Ave
Ste 154
East Hanover, NJ 07936
Phone (201) 407-5145

51 Madison Ave
Madison, NJ 07940
Phone (973) 377-2124

111 E 210th St
Bronx, NY 10467

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1700249216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14445 SANFORD AVE",
            "address_2": "APT 4A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551679",
            "telephone_number": "347-259-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 SANFORD AVE",
            "address_2": "APT 4A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551679",
            "telephone_number": "347-259-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "NAN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-01",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.