Individual provider Active NPI

Lillian Wang

  • Physician Assistant
  • Mesquite, TX
National Provider Identifier
1710451372
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12326 Issued in TX
Practice address
2704 N Galloway Ave Ste 101
Mesquite, TX 75150-6379
Phone
(972) 288-3376
Fax
(972) 288-3377
NPI assigned
Jan 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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 PA12326 TX Primary

Addresses

Primary practice location

2704 N Galloway Ave Ste 101
Mesquite, TX 75150-6379

Mailing address

2704 N Galloway Ave Ste 101
Mesquite, TX 75150-6379
Phone (972) 288-3376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190205002781 TX Practitioner - Physician Assistant 0840538500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epiphany Dermatology PAGroup PAC ID 3971827791, 106 clinicians

Practice addresses (Care Compare)

215 S Denton Tap Rd
Suite 170
Coppell, TX 75019-5066
Phone (469) 312-7302

2704 N Galloway Ave
Suite 101
Mesquite, TX 75150-6379
Phone (972) 288-3376

7106 New Sanger Rd
Waco, TX 76712-3928
Phone (254) 537-1265

Merit-based Incentive Payment System (MIPS)

Final score
83.97 of 100Reported as group
Quality
76.91
Promoting interoperability
91
Improvement activities
40
Cost
77.16

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: lillian.wang@epiphanyderm.emadirect.md

Organizations & group practices 1

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": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1710451372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 N GALLOWAY AVE STE 101",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506379",
            "telephone_number": "972-288-3376",
            "fax_number": "972-288-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 N GALLOWAY AVE STE 101",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506379",
            "telephone_number": "972-288-3376",
            "fax_number": "972-288-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "LILLIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.