Individual provider Active NPI

Shudan Wang, M.D.

  • Rheumatology Physician
  • Scarsdale, NY
National Provider Identifier
1831432780
Registry record updated Jul 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
293017 Issued in NY
Practice address
495 Central Park Ave
Scarsdale, NY 10583
Phone
(866) 633-8255
NPI assigned
Mar 28, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 293017 NY Primary

Addresses

Primary practice location

495 Central Park Ave
Scarsdale, NY 10583

Mailing address

495 Central Park Ave
Scarsdale, NY 10583-1068

Other practice location 1

111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-4321

Other practice location 2

150 White Plains Rd
Tarrytown, NY 10591-5535
Phone (914) 631-2895

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180725003365 NY Practitioner - RheumatologyPractitioner - Internal Medicine 8921392564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Rutgers New Jersey Medical School, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
293017NYMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jun 15, 2018 Accepting new patients
Montefiore Medical Center Rheumatology CurrentSince Jun 15, 2018 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

555 Taxter Rd
Fl 3
Elmsford, NY 10523
Phone (914) 457-4130

555 Taxter Rd
Elmsford, NY 10523
Phone (718) 920-2587

495 Central Park Ave
Scarsdale, NY 10583
Phone (844) 556-6683

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: shuwang@montefioredirect.com
  • Direct secure messaging: swang842108@nychhc.direct-ci.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530403200000",
    "number": "1831432780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 CENTRAL PARK AVE",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 CENTRAL PARK AVE",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "10583",
            "telephone_number": "866-633-8255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 White Plains Rd",
            "address_purpose": "LOCATION",
            "city": "Tarrytown",
            "state": "NY",
            "postal_code": "105915535",
            "country_code": "US",
            "telephone_number": "914-631-2895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "SHUDAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-28",
        "last_updated": "2018-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "293017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

Verify at the official NPI Registry.