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KETTY C WANG NP
NPI 1740053529
Nurse Practitioner in Santa Cruz, CA

Active since November 02, 2023PECOS EnrolledAccepts Medicare Assignment
1667 DOMINICAN WAY STE 230, SANTA CRUZ, CA 95065(831) 458-6288(831) 477-9026 Get Directions Write a Review

NPPES record last updated: July 22, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 22, 2026, Nov 2, 2023 (2 updates tracked since 2023).

About Ketty C Wang Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KETTY C WANG NP (NPI 1740053529) is an individual nurse practitioner in Santa Cruz, California, licensed in California (95027289) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Stanford, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1740053529
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameKETTY C WANGCredential: NP
Location Address1667 DOMINICAN WAY STE 230Santa Cruz, CA 95065-1560
Mailing Address300 Pasteur DrStanford, CA 94305-2200 · (650) 723-4000
Phone(831) 458-6288
Fax(831) 477-9026
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateNovember 2, 2023
Last NPPES UpdateJuly 22, 20262 updates tracked since enumeration
NPPES CertifiedJuly 22, 2026
✔ NPI 1740053529 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CA · 95027289
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · Critical Care MedicineTaxonomy 363LC0200X · License 95027289 (CA)
1667 DOMINICAN WAY STE 230, Santa Cruz, CA 95065
Open in Google Maps ↗

Secondary Practice Location 1

Location 1300 Pasteur DrStanford, CA 94305-2200 · Phone (650) 723-4000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ketty C Wang Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5294184479
PECOS Enrollment IDI20231213001893
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Ketty Wang reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Stanford Health Care
32 mi
General Acute Care Hospital
300 PASTEUR DRIVE
Stanford, CA 94305
  • Reassigned Medicare billing, California enrollment
  • 4,258 clinicians in this Medicare group
NPI 1437292927 (650) 723-4000
Sutter Bay Medical Foundation
33 mi
Multi-Specialty
795 EL CAMINO REAL
Palo Alto, CA 94301
  • Reassigned Medicare billing, California enrollment
  • 4,479 clinicians in this Medicare group
NPI 1013950807 (650) 321-4121
Lpch Medical Group Div Of Lucile
33 mi
Children
725 WELCH RD
Palo Alto, CA 94304
  • Reassigned Medicare billing, California enrollment
  • 3,617 clinicians in this Medicare group
NPI 1417907940 (650) 498-6762

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95065 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.03 typical visit price
range $62.97 – $186.69
Typical copayment $24.00 (range $15.74 – $46.67)
Most-billed visit code 99203
Established Patient
$109.72 typical visit price
range $21.02 – $153.16
Typical copayment $27.43 (range $5.25 – $38.29)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAY A JOHNSON MD INC
Internal Medicine (Cardiovascular Disease)
1667 DOMINICAN WAY STE 230
SANTA CRUZ, CA 95065
Santa Cruz County (831) 464-3801
APRIL KANSCHAT PA-C
Physician Assistant (Surgical)
1667 DOMINICAN WAY STE 230
SANTA CRUZ, CA 95065
Santa Cruz County (831) 458-6288
SCOTT E MACNAUGHTON PA
Physician Assistant
1667 DOMINICAN WAY STE 230
SANTA CRUZ, CA 95065
Santa Cruz County (831) 458-6288

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ketty Wang's NPI number?

The NPI number for Ketty Wang is 1740053529. It was assigned to this individual provider in the NPPES registry on November 2, 2023.

Where is Ketty Wang located?

Ketty Wang practices at 1667 Dominican Way Ste 230, Santa Cruz, CA 95065. The listed phone number is (831) 458-6288.

What is Ketty Wang's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Ketty Wang enrolled in Medicare?

Yes. Ketty Wang is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Ketty Wang's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ketty Wang reassigns Medicare benefits to 3 organizations: Stanford Health Care (Stanford, CA), Sutter Bay Medical Foundation (Palo Alto, CA) and Lpch Medical Group Div Of Lucile (Palo Alto, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ketty Wang's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ketty Wang was last updated on July 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.