Marilyn Wan

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

333202 Issued in NY

Practice address

1991 Marcus Ave
New Hyde Park, NY 11042-2057

Phone

(516) 321-8509

NPI assigned

Jul 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bobby Buka, M.D., P.C.Group PAC ID 0547351140, 140 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22363/brand/1/csg/1/fhir/r4

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.

• Bobby Buka, M.D., P.C.

  • Dermatology Physician
  • New York, NY
  • NPI 1134349954
  Medicare reassignment Care Compare group
• Derm Specs of PA PLLC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1528823507
  NPD
• Mount Sinai Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1932103413
  NPD (past)
• Out East Medical

  • Dermatology Physician
  • Oceanside, NY
  • NPI 1730757311
  NPD (past)
• Atlas Infectious Disease Practice PLLC

  • Infectious Disease Physician
  • Atlantis, FL
  • NPI 1326655846
  NPD (past)

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1710504816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 SIEAFORTH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152161436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422057",
            "telephone_number": "516-321-8509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 N Flamingo Rd",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281006",
            "country_code": "US",
            "telephone_number": "617-676-5452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAN",
        "first_name": "MARILYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "333202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Elizabeth Walsh, M.D.
• Pamela J Walsh, M.D.
• Ruth Sarai Walter, PHYSICIAN ASSISTANT
• Heather Marie Walters, MD
• Kason Wan, PA
• Chaoyang Wang
• Gloria Zhujun Wang, MD
• Jack Jiawei Wang, MD
• Janice Wang, M.D.
• Jue Wang

• Dermatology Physician in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.