Individual provider Active NPI

Harrison Jin-Sui Wu, DO

  • Family Medicine Physician
  • Burbank, CA
National Provider Identifier
1831779149
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A21464 Issued in CA
Practice address
191 S Buena Vista St Ste 100
Burbank, CA 91505-4562
Phone
(818) 869-7600
NPI assigned
Apr 11, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A21464 CA Primary

Addresses

Primary practice location

191 S Buena Vista St Ste 100
Burbank, CA 91505-4562

Mailing address

191 S Buena Vista St Ste 100
Burbank, CA 91505-4562
Phone (818) 869-7600

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240925000744 CA Practitioner - Family Practice 7113468539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Facey Medical FoundationGroup PAC ID 3173436276, 324 clinicians

Practice addresses (Care Compare)

11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone (818) 365-9531

19950 Rinaldi St
Porter Ranch, CA 91326-4141
Phone (818) 403-2400

501 S Buena Vista St
Burbank, CA 91505-4809
Phone (818) 847-6049

503 S Buena Vista St
Suite 101
Burbank, CA 91505-4809
Phone (818) 869-7630

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A21464CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Facey Medical Foundation Family Medicine CurrentSince Sep 9, 2024 Accepting new patients
Providence Facey Medical Foundation CurrentSince Sep 9, 2024 Accepting new patients

Locations

191 S Buena Vista St
Ste 100
Burbank, CA 91505
Phone (818) 869-7600

File 50670
Los Angeles, CA 90074

18460 Roscoe Blvd
Northridge, CA 91325
Phone (818) 734-3600

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1618099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1831779149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST STE 100",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054562",
            "telephone_number": "818-869-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST STE 100",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054562",
            "telephone_number": "818-869-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "HARRISON",
        "middle_name": "JIN-SUI",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-11",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A21464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.