Active NPI
Philip Wong, MD
- Urology Physician
- Toledo, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 35.139772
- Practice address
- 2120 W Central Ave
Toledo, OH 43606-3834 - Phone
- (419) 531-8558
- Fax
- (419) 697-7705
- NPI assigned
- Feb 27, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 4301502613 | MI | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Urology Physician | 208800000X | 35.139772 | OH | Primary |
Addresses
Primary practice location
2120 W Central Ave
Toledo, OH 43606-3834
Mailing address
1 Seagate Ste 800
Toledo, OH 43604-1558
Phone (419) 531-8558
Other practice location 1
214 E Elm Ave Ste 101
Monroe, MI 48162-2678
Phone (734) 243-9620
Other practice location 2
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-7026
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pwong194434@epicdirect.promedica.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- University of Toledo College of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2120 W Central Ave
Toledo, OH 43606-3834
Phone (419) 531-8558
905 N Macomb St
5 Promedica Genito Urinary LLC
Monroe, MI 48161-3076
Phone (734) 243-9620
Hospital & facility affiliations
- Promedica Toledo Hospital
- Bay Park Community Hospital
- Promedica Charles and Virginia Hickman Hospital
- Promedica Monroe Regional Hospital
- Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 18 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301502613 | MI | MD | Urology Physician |
| 35.139772 | OH | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Promedica Genito-Urinary Surgeons LLC | Urology | Current | Accepting new patients |
| Genito Urinary Surgeons, Inc | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
905 N Macomb St
Ste 5
Monroe, MI 48162
Phone (734) 243-9620
214 E Elm Ave
Ste 101
Monroe, MI 48162
Phone (734) 243-9620
2751 Bay Park Dr
Ste 303
Oregon, OH 43616
Phone (419) 690-7676
1 Seagate
Ste 800
Toledo, OH 43604
2120 W Central Ave
Toledo, OH 43606
Phone (419) 531-8558
Interoperability endpoints
- pwong194434@direct.promedica.org
Organizations & group practices 3
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.
-
- Durable Medical Equipment & Medical Supplies
- Toledo, OH
- NPI 1861530909
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Oregon, OH
- NPI 1598765539
-
- General Acute Care Hospital
- Fremont, OH
- NPI 1851338149
-
- General Acute Care Hospital
- Toledo, OH
- NPI 1407854771
-
- General Acute Care Hospital
- Adrian, MI
- NPI 1972564730
-
- General Acute Care Hospital
- Monroe, MI
- NPI 1811097223
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1003208026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 SEAGATE STE 800",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436041558",
"telephone_number": "419-531-8558",
"fax_number": "419-697-7705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2120 W CENTRAL AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436063834",
"telephone_number": "419-531-8558",
"fax_number": "419-697-7705"
}
],
"practiceLocations": [
{
"address_1": "214 E Elm Ave Ste 101",
"address_purpose": "LOCATION",
"city": "Monroe",
"state": "MI",
"postal_code": "481622678",
"country_code": "US",
"telephone_number": "734-243-9620",
"fax_number": "734-243-3565",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2799 W Grand Blvd",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482022608",
"country_code": "US",
"telephone_number": "313-916-7026",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WONG",
"first_name": "PHILIP",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-02-27",
"last_updated": "2023-11-03",
"certification_date": "2020-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MI",
"license": "4301502613",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "OH",
"license": "35.139772",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pwong194434@epicdirect.promedica.org",
"affiliation": "N",
"address_1": "100 Madison Ave",
"city": "Toledo",
"state": "OH",
"country_code": "US",
"postal_code": "436041516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.