Guobin Wang, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

014501 Issued in NY

Practice address

5847 188TH St
Fresh Meadows, NY 11365-2201

Phone

(718) 357-8200

Fax

(718) 357-5770

NPI assigned

Apr 19, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology PCGroup PAC ID 3274526850, 67 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

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

Interoperability endpoints

• Direct secure messaging: gwang@advderm.emadirect.md

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.

• Advanced Dermatology PC

  • Dermatology Physician
  • New Hyde Park, NY
  • NPI 1134201460
  Medicare reassignment Care Compare group
• Dr WW Dermatology PLLC

  • Specialist
  • Elmhurst, NY
  • NPI 1477891901
  Medicare reassignment
• Anthony Buglino DO PLLC

  • Plastic Surgery Physician
  • Woodbury, NY
  • NPI 1730582834
  NPD (past)
• Howard D. Solomon, DO, PC

  • Procedural Dermatology Physician
  • Forest Hills, NY
  • NPI 1598054520
  NPD (past)
• W&W Millennium Dermatology P.C.

  • Specialist
  • New York, NY
  • NPI 1134300254
  NPD (past)

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1871850503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 LOWELL AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402810",
            "telephone_number": "516-326-4160",
            "fax_number": "516-354-3916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5847 188TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652201",
            "telephone_number": "718-357-8200",
            "fax_number": "718-357-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "GUOBIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "003377",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Vinceslio
• Natalja Vranga
• Walgreen Co
• Teena C Walker, MFT
• Fe Gonzales Walton, RN
• Teresa Wang
• Xiaodong Wang Sr.
• Jaclyn Marie Watson, M.A. CCC-SLP
• Shira Waxman Shatzkes, MS OTR/L
• Leora Ann Waxman

• Physician Assistant in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.