Active NPI
Dafang Wu, MD
- Nuclear Medicine Physician
- Sacramento, CA
National Provider Identifier
1871553834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nuclear Medicine Physician
- License
- A77987
- Practice address
- 3195 Folsom Blvd Ste 110
Sacramento, CA 95816-5264 - Phone
- (916) 378-5541
- Fax
- (916) 739-0789
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Medicine Physician | 207U00000X | 4301081007 | MI | |
| Nuclear Medicine Physician | 207U00000X | A77987 | CA | Primary |
Addresses
Primary practice location
3195 Folsom Blvd Ste 110
Sacramento, CA 95816-5264
Mailing address
3195 Folsom Blvd Ste 110
Sacramento, CA 95816-5264
Phone (916) 378-5541
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220330000574 | CA | Practitioner - Nuclear Medicine | 7810928249 | Practice locations: Sacramento, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A77987 | CA | MD | Nuclear Medicine Physician |
| 4301081007 | MI | MD | Nuclear Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern California P.E.T. Imaging Center | Nuclear Medicine | Current | Accepting new patients |
| Northern California P.E.T. Imaging Center | Nuclear Medicine | Current | Accepting new patients |
| Northern California P.E.T. Imaging Center | Nuclear Medicine | Current | Accepting new patients |
| Dr L Reynolds Assoc PC | Past | Accepting new patients |
Locations
3718 Atherton Rd
Rocklin, CA 95765
Phone (916) 737-3211
3195 Folsom Blvd
Ste 110
Sacramento, CA 95816
Phone (916) 737-3211
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 4
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.
-
- Nuclear Medicine Physician
- Rocklin, CA
- NPI 1659069672
-
- Nuclear Medicine Physician
- Roseville, CA
- NPI 1790734317
-
- Radiology Clinic/Center
- Sacramento, CA
- NPI 1992754741
Nuclear Medicine
-
- Specialist
- Southfield, MI
- NPI 1669423265
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651708800000",
"number": "1871553834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3195 FOLSOM BLVD STE 110",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165264",
"telephone_number": "916-378-5541",
"fax_number": "916-739-0789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3195 FOLSOM BLVD STE 110",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165264",
"telephone_number": "916-378-5541",
"fax_number": "916-739-0789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WU",
"first_name": "DAFANG",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-24",
"last_updated": "2022-05-05",
"certification_date": "2022-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "207U00000X",
"taxonomy_group": "",
"desc": "Nuclear Medicine",
"state": "MI",
"license": "4301081007",
"primary": false
},
{
"code": "207U00000X",
"taxonomy_group": "",
"desc": "Nuclear Medicine",
"state": "CA",
"license": "A77987",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.