Active NPI
Yuxuan Jerry Wang, M.D.
- Trauma Surgery Physician
- Vancouver, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Trauma Surgery Physician
- License
- MD60862280
- Practice address
- 505 NE 87TH Ave Ste 301
Vancouver, WA 98664-1965 - Phone
- (360) 514-1854
- NPI assigned
- Jun 21, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | A131054 | CA | |
| Surgery Physician | 208600000X | MD60862280 | WA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Trauma Surgery Physician | 2086S0127X | MD60862280 | WA | Primary |
Addresses
Primary practice location
505 NE 87TH Ave Ste 301
Vancouver, WA 98664-1965
Mailing address
26520 Cactus Ave.
Rcrmc General Residency Residency Program
Moreno Valley, CA 92555
Other practice location 1
26520 Cactus Ave
General Surgery Residency Program
Moreno Valley, CA 92555-3927
Phone (951) 486-5908
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- University of New Mexico School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
505 NE 87TH Ave
Vancouver, WA 98664-1965
8821 NE 5TH St
Vancouver, WA 98664-3200
Phone (360) 514-1900
Hospital & facility affiliations
- Peacehealth Southwest Medical Cente
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A131054 | CA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth | Surgery | Current | Accepting new patients |
| Peacehealth | Past | Accepting new patients |
Locations
505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854
1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100
Interoperability endpoints
- ywang390146@direct.peacehealth.org
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 and National Provider Directory roles.
-
- Surgery Physician
- Vancouver, WA
- NPI 1609061969
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1134178999
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1134178999
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531958400000",
"number": "1821351099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26520 CACTUS AVE.",
"address_2": "RCRMC GENERAL RESIDENCY RESIDENCY PROGRAM",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "92555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 NE 87TH AVE STE 301",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986641965",
"telephone_number": "360-514-1854"
}
],
"practiceLocations": [
{
"address_1": "26520 Cactus Ave",
"address_2": "General Surgery Residency Program",
"address_purpose": "LOCATION",
"city": "Moreno Valley",
"state": "CA",
"postal_code": "925553927",
"country_code": "US",
"telephone_number": "951-486-5908",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WANG",
"first_name": "YUXUAN",
"middle_name": "JERRY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-21",
"last_updated": "2018-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "A131054",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WA",
"license": "MD60862280",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "WA",
"license": "MD60862280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.