Individual provider Active NPI

Sonya Grace Wang, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Minneapolis, MN
National Provider Identifier
1790997393
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
63198 Issued in MN
Practice address
5775 Wayzata Blvd Ste 255
Minneapolis, MN 55416-1275
Phone
(952) 525-4450
Fax
(952) 525-1560
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X A117466 CA
Clinical Neurophysiology Physician 2084N0600X A117466 CA
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 63198 MN Primary

Addresses

Primary practice location

5775 Wayzata Blvd Ste 255
Minneapolis, MN 55416-1275

Mailing address

5775 Wayzata Blvd Ste 255
Minneapolis, MN 55416-1275
Phone (952) 525-4450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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

Enrollment IDStateProvider typePAC IDDetails
I20180123001036 MN Practitioner - Neurology 5890831408 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Vanderbilt University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

2025 E River Pkwy
Minneapolis, MN 55414-3604
Phone (612) 301-0115

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A117466CAMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Physicians CurrentSince Dec 21, 2017 Accepting new patients
Fairview Express Care Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Dec 21, 2017 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Dec 21, 2017 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
University of Minnesota Physicians CurrentSince Dec 21, 2017 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

2025 E River Rd
Minneapolis, MN 55414
Phone (612) 301-0115

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

5775 Wayzata Blvd
Ste 255
St Louis Park, MN 55416
Phone (612) 273-8710

9680 Tamarack Rd
Ste 130
Woodbury, MN 55125
Phone (612) 273-1172

Interoperability endpoints

  • Direct secure messaging: swang427839@fairview.direct-ci.com

Organizations & group practices 9

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1790997393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD STE 255",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554161275",
            "telephone_number": "952-525-4450",
            "fax_number": "952-525-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD STE 255",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554161275",
            "telephone_number": "952-525-4450",
            "fax_number": "952-525-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "SONYA",
        "middle_name": "GRACE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "CA",
            "license": "A117466",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "A117466",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MN",
            "license": "63198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.