Kyne Martin Wang, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

9901075 Issued in NC

Practice address

4022 Freedom Lake Dr
Durham, NC 27704

Phone

(919) 477-2202

Fax

(919) 471-2270

NPI assigned

Apr 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwang50002@direct.medicine.duke.edu

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.

• Duke Health Integrated Practice, Inc.

  • General Practice Physician
  • Durham, NC
  • NPI 1205553369
  Medicare reassignment NPD

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

{
    "created_epoch": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1962468660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4022 FREEDOM LAKE DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27704",
            "telephone_number": "919-477-2202",
            "fax_number": "919-471-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4022 FREEDOM LAKE DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27704",
            "telephone_number": "919-477-2202",
            "fax_number": "919-471-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "KYNE",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9901075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2242290",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI ALLIANCE",
            "identifier": "273703",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS STATE FEDERAL NC HEA",
            "identifier": "1216U",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1255307",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891216U",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "88979",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAROLINA ACCESS NC",
            "identifier": "8912160",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Wang, M.D.
• Chunsheng Joseph Wang, MD., PHD
• Dingyuan Alvin Wang, MBBS
• Emily Sarah Wang
• Jiaxing Wang, MD, PHD
• Li Wang, ARNP
• Liming Wang
• Runping Wang, MASTER DEGREE
• Weiwei Wang, N.P.
• Xiaojun Wang, DDS

• Pediatrics Physician in Durham, NC
• Providers in Durham, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.

Verify at the official NPI Registry.