Individual provider Active NPI

Mark James Wang, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Phoenix, AZ
National Provider Identifier
1881806834
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
45261 Issued in AZ
Practice address
1635 E Myrtle Ave Ste 400
Phoenix, AZ 85020-5514
Phone
(602) 944-2900
Fax
(602) 944-0064
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A83999 CA
Orthopaedic Surgery of the Spine Physician 207XS0117X 45261 AZ Primary

Addresses

Primary practice location

1635 E Myrtle Ave Ste 400
Phoenix, AZ 85020-5514

Mailing address

1635 E Myrtle Ave Ste 400
Phoenix, AZ 85020-5514
Phone (602) 944-2900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mark.wang.p1@direct.sciatica.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20120517000345 AZ Practitioner - Orthopedic Surgery 0143315606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of California, Geffen School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Desert Institute for Spine Care PCGroup PAC ID 1951347475, 13 clinicians

Practice addresses (Care Compare)

1635 E Myrtle Ave
Suite 400
Phoenix, AZ 85020-5514
Phone (602) 944-2900

3487 S Mercy Rd
Gilbert, AZ 85297-0432
Phone (602) 944-2900

8630 E Via de Ventura
Suite 210
Scottsdale, AZ 85258-3358
Phone (602) 944-2900

Hospital & facility affiliations

  • Haven Home Health Care Home health agency, Scottsdale, AZ, CCN 037492
  • Haven Home Health Care Home health agency, Tucson, AZ, CCN 037494
  • Arizona Orthopedic and Surgical Specialty Hospital Hospital, Phoenix, AZ, CCN 030112
  • Honorhealth Scottsdale Shea Medical Center Hospital, Scottsdale, AZ, CCN 030087

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion464
Laminectomy or laminotomy (partial removal of spine bones)258

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A83999CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Health Sciences, PLLC Current Accepting new patients
Desert Institute for Spine Care PC CurrentSince Jan 1, 2021 Accepting new patients
Torrance Health Association Inc Family Medicine Past Accepting new patients
South Bay Orthopaedic Specialists Medical Center a Medical Partnership Orthopaedic Surgery PastSince Oct 1, 2001 Accepting new patients

Locations

3487 S Mercy Rd
Gilbert, AZ 85297
Phone (480) 222-5601

1635 E Myrtle Ave
Ste 400
Phoenix, AZ 85020
Phone (602) 216-6081

1635 E Myrtle Ave
Ste 100
Phoenix, AZ 85020
Phone (602) 536-4625

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: mjw113pcs@m1642.primeclinicalsystems.direct-ci.com

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.

Hospital & facility affiliations 4

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1881806834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 E MYRTLE AVE STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205514",
            "telephone_number": "602-944-2900",
            "fax_number": "602-944-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 E MYRTLE AVE STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205514",
            "telephone_number": "602-944-2900",
            "fax_number": "602-944-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "MARK",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A83999",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "AZ",
            "license": "45261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.wang.p1@direct.sciatica.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1635 E Myrtle Ave Ste 400",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850205514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.