Individual provider Active NPI

Shuju Wang

  • Medical Physician Assistant
  • Warren, MI
National Provider Identifier
1801832696
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601003538 Issued in MI
Practice address
26811 Ryan Rd
Warren, MI 48091-4075
Phone
(586) 755-4433
Fax
(586) 755-6655
NPI assigned
Jun 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601003538 MI Primary

Addresses

Primary practice location

26811 Ryan Rd
Warren, MI 48091-4075

Mailing address

26811 Ryan Rd
Warren, MI 48091-4075
Phone (586) 755-4433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20080118000706 MI Practitioner - Physician Assistant 2264513944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Behavioral Care Solutions for Adults and Seniors IncGroup PAC ID 4880918051, 71 clinicians

Practice addresses (Care Compare)

39465 W 14 Mile Rd
Novi, MI 48377-1600
Phone (877) 906-9699

Merit-based Incentive Payment System (MIPS)

Final score
57.96 of 100Reported as group
Quality
21.71
Promoting interoperability
12
Improvement activities
40
Cost
78.16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601003538MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric Psychiatric Services PLLC Past Accepting new patients

Organizations & group practices 2

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801832696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26811 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480914075",
            "telephone_number": "586-755-4433",
            "fax_number": "586-755-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26811 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480914075",
            "telephone_number": "586-755-4433",
            "fax_number": "586-755-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "SHUJU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601003538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.