Individual provider Active NPI

Mengya Wang

  • Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1710863667
Registry record updated Sep 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95036546 Issued in CA
Practice address
1870 Lundy Ave
San Jose, CA 95131-1826
Phone
(415) 391-9686
NPI assigned
Aug 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95036546 CA Primary

Addresses

Primary practice location

1870 Lundy Ave
San Jose, CA 95131-1826

Mailing address

1870 Lundy Ave
San Jose, CA 95131-1826

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251027002324 CA Practitioner - Nurse Practitioner 2062901531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North East Medical ServicesGroup PAC ID 4284520529, 143 clinicians

Practice addresses (Care Compare)

1520 Stockton St
San Francisco, CA 94133-3354
Phone (415) 391-9686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95036546CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North East Medical Services CurrentSince Oct 1, 2025 Accepting new patients
North East Medical Services Current Accepting new patients
North East Medical Services CurrentSince Oct 1, 2025 Accepting new patients

Locations

211 Eastmoor Ave
Daly City, CA 94015
Phone (650) 550-3923

82 Leland Ave
San Francisco, CA 94134
Phone (415) 391-9688

1520 Stockton St
San Francisco, CA 94133

1870 Lundy Ave
San Jose, CA 95131
Phone (408) 573-9686

Organizations & group practices 3

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": "1755129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757721600000",
    "number": "1710863667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 LUNDY AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951311826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 LUNDY AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951311826",
            "telephone_number": "415-391-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "MENGYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-14",
        "last_updated": "2025-09-13",
        "certification_date": "2025-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95036546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.