FANGDA JIANG MD NPI 1255955159

NPI Information

NPI: 1255955159
Provider Name: FANGDA JIANG, MD
Classification: Hospitalist - 208M00000X
Entity Type: Individual
PECOS Registration: Yes
Address: 210 WISCONSIN AMERICAN DR
FOND DU LAC, WI
ZIP 54937
Phone: (920) 907-7500

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NPI Details

Fangda Jiang, MD is a hospitalist in Fond Du Lac, WI with 7 years of experience. The provider is hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. Fangda Jiang, MD NPI is 1255955159. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduation Year:2019

The provider's business location address is:

210 WISCONSIN AMERICAN DR
FOND DU LAC, WI
ZIP 54937-999
Phone: (920) 907-7500

The NPI 1255955159 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/5/2020 and was last updated on 1/28/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	207Q00000X	Family Medicine	PT20162	NORTH DAKOTA	No
2	390200000X	Student in an Organized Health Care Education/Training Program	MT221145	PENNSYLVANIA	No
3	207Q00000X	Family Medicine	84732	WISCONSIN	No
4	208M00000X	Hospitalist	84732	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100297012	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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