Individual provider Active NPI

Serena Ke Jun Wang, MD

  • Internal Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1851634786
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A135917 Issued in CA
Practice address
2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2023
Phone
(310) 582-6200
NPI assigned
Mar 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A135917 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X CA

Addresses

Primary practice location

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2023

Mailing address

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2023
Phone (310) 582-6200

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
I20160527001479 CA Practitioner - Internal Medicine 2365732609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 1355248584, 1,426 clinicians

Practice addresses (Care Compare)

2020 Santa Monica Blvd
Santa Monica, CA 90404-2023
Phone (310) 458-2381

Hospital & facility affiliations

  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112
  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A135917CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Jun 30, 2016 Accepting new patients
The Regents of the University of California Internal Medicine CurrentSince Jun 30, 2016 Accepting new patients
Providence Saint John'S Health Center Past Accepting new patients
UCLA Medical Group Internal Medicine Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 55737
Los Angeles, CA 90074

2020 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 458-2381

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

Interoperability endpoints

  • Direct secure messaging: swang462562@direct.uclahealth.org

Organizations & group practices 5

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 2

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": "1459209600000",
    "number": "1851634786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 SANTA MONICA BLVD",
            "address_2": "SUITE 210",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042023",
            "telephone_number": "310-582-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 SANTA MONICA BLVD",
            "address_2": "SUITE 210",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042023",
            "telephone_number": "310-582-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "SERENA",
        "middle_name": "KE JUN",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-28",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A135917",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.