GRACE A. WAN MD
NPI 1962550749
Family Medicine in Fontana, CA
About Grace A. Wan Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GRACE A. WAN MD (NPI 1962550749) is an individual family medicine provider in Fontana, California, licensed in California (G77677) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Grace A. Wan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Grace Wan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fontana, CA 92335
- Reassigned Medicare billing, California enrollment
- 5,228 clinicians in this Medicare group
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 92335 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FONTANA, CA 92335
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 Grace Wan's NPI number?
The NPI number for Grace Wan is 1962550749. It was assigned to this individual provider in the NPPES registry on January 8, 2007.
Where is Grace Wan located?
Grace Wan practices at 9961 Sierra Ave, Fontana, CA 92335. The listed phone number is (909) 427-3910.
What is Grace Wan's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Grace Wan enrolled in Medicare?
Yes. Grace Wan is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Grace Wan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Grace Wan reassigns Medicare benefits to Southern California Permanente Medical Group (Fontana, CA). The 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 Grace Wan'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 Grace Wan was last updated on November 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.
# Grace A. Wan, MD · NPI 1962550749
Family Medicine physician in Fontana, California. Individual provider, active in the CMS NPPES registry since January 8, 2007.
## Identity
- **NPI:** 1962550749 (Entity type: Individual)
- **Enumerated:** January 8, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** G77677 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 9961 SIERRA AVE, Fontana, CA 92335-6720
- **Phone:** (909) 427-3910
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1689606196, Fontana, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 29, 2021
---
Source: [NPI Profile](https://npiprofile.com/npi/1962550749) · Data from the CMS NPPES public registry.