Individual provider Active NPI

Eugene P. Wang, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Petoskey, MI
National Provider Identifier
1922063908
Registry record updated Mar 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
47083 Issued in WI
Practice address
2375 Summit Park Dr
Petoskey, MI 49770-8685
Phone
(231) 348-3283
Fax
(231) 348-3331
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 47083 WI Primary

Addresses

Primary practice location

2375 Summit Park Dr
Petoskey, MI 49770-8685

Mailing address

2375 Summit Park Dr
Petoskey, MI 49770-8685
Phone (231) 348-3283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20071012000141 MI Practitioner - Physical Medicine and Rehabilitation 2466548078 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Michigan State University College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northern Michigan Substance Abuse Services IncGroup PAC ID 3971818998, 4 clinicians
Eugene P Wang DO PCGroup PAC ID 5294821807, 6 clinicians

Practice addresses (Care Compare)

2136 W
Suite 32
Gaylord, MI 49735-9282
Phone (989) 732-1791

2375 Summit Park Dr
Petoskey, MI 49770-8685
Phone (231) 348-3283

Hospital & facility affiliations

  • McLaren Northern Michigan Hospital, Petoskey, MI, CCN 230105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47083WIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Michigan Substance Abuse Services, Inc. CurrentSince Jun 24, 2015 Accepting new patients
Eugene P Wang, DO PC Physical Medicine & Rehabilitation CurrentSince Jun 1, 2007 Accepting new patients
Harbor Hall, Inc. Past Accepting new patients

Locations

2922 D and M Dr
Ste B
Gaylord, MI 49735
Phone (231) 348-3283

2136 W M 32
Gaylord, MI 49735
Phone (989) 732-1791

2922 D and M Dr
Gaylord, MI 49735
Phone (231) 348-3283

948 N Center Ave
Gaylord, MI 49735
Phone (989) 448-2004

2375 Summit Park Dr
Petoskey, MI 49770
Phone (231) 348-3283

Organizations & group practices 3

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268092800000",
    "number": "1922063908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 SUMMIT PARK DR",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708685",
            "telephone_number": "231-348-3283",
            "fax_number": "231-348-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 SUMMIT PARK DR",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708685",
            "telephone_number": "231-348-3283",
            "fax_number": "231-348-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "EUGENE",
        "middle_name": "P.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2010-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "47083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

Verify at the official NPI Registry.