Individual provider Active NPI

Dafang Wu, MD

  • Nuclear Medicine Physician
  • Sacramento, CA
National Provider Identifier
1871553834
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Medicine PhysicianTaxonomy code 207U00000X
License
A77987 Issued in CA
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

Updated by the provider on May 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
A77987CAMDNuclear Medicine Physician
4301081007MIMDNuclear Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern California P.E.T. Imaging Center Nuclear Medicine CurrentSince Feb 14, 2022 Accepting new patients
Northern California P.E.T. Imaging Center Nuclear Medicine CurrentSince Jan 13, 2022 Accepting new patients
Northern California P.E.T. Imaging Center Nuclear Medicine CurrentSince Jan 13, 2022 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

  • FHIR API: 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.

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

Verify at the official NPI Registry.