XIN WANG (PA-C) – Physician Assistant, NPI 1083450407

XIN WANG (PA-C) is a healthcare provider. based in Pomona, California. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA3108 (NV). The NPI Number for XIN WANG (PA-C) is 1083450407

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
XIN WANG (PA-C)
NPI
1083450407
Phone
(909) 623-6116
Address
309 E 2ND ST
Enumeration Date
4 July 2024
Last Update Date
11 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7024563120
Graduation Year
2024 (2 years ago)
PAC ID
7416481437
Group Practice PAC ID
6204232275
Professional Enrollment ID
I20241113004520
Address ID
NV891440518LA653XXDRXX506
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

1,223 PHYSICIAN ASSISTANT in NV

Provider Addresses for XIN WANG (PA-C)

  • 309 E 2ND ST

    POMONA, CA 917661854

    Phone: (909) 623-6116

    Type: Mailing

  • 653 N TOWN CENTER DR STE 414

    LAS VEGAS, NV 891440518

    Phone: (702) 456-3120

    Fax: (702) 823-1069

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 12 Open Payments records for all available years, with a total value of $677.

Total Amount is formed as General ($677) + Research ($0) + Ownership ($0) = $677.

Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Dermavant Sciences, Inc. ($180).

Total Amount

$677

General + Research + Ownership

Payments

12

Total payment records

General Amount

$677

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-16

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241113004520IPhysician AssistantNVTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91766)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6204232275View full group profile
NameSpecialtyState
Physician AssistantNV
Internal Medicine, DermatologyNV
Nurse PractitionerNV
D E R M A T O L O G YMO
D E R M A T O L O G YTX
Physician AssistantGA

Reviews

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Frequently asked questions

Does XIN WANG (PA-C) have a public NPI I can cite?
Public records show XIN WANG (PA-C) under NPI 1083450407.
Is XIN WANG (PA-C)'s NPI status active today?
Active status means XIN WANG (PA-C)'s NPI record is not deactivated in the public file.
What does the directory say XIN WANG (PA-C) does?
Insurance directories may phrase it differently, but here XIN WANG (PA-C) maps to Physician Assistant. Clinical services aligned with this taxonomy classification.
What city is tied to XIN WANG (PA-C)?
The directory associates XIN WANG (PA-C) with Pomona, California. Check all listed addresses for suites or satellite offices.
Can I export XIN WANG (PA-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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