Individual provider Active NPI

Jeffrey Wong, OT

  • Occupational Therapist
  • Warner Robins, GA
National Provider Identifier
1033455027
Registry record updated Mar 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT006093 Issued in GA
Practice address
3051 Watson Blvd Ste 525
Warner Robins, GA 31093-8556
Phone
(478) 953-4564
NPI assigned
Dec 19, 2012
Last updated
Mar 4, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC012643 PA
Occupational Therapist 225X00000X U1-0001457 DE
Occupational Therapist 225X00000X OT006093 GA Primary

Addresses

Primary practice location

3051 Watson Blvd Ste 525
Warner Robins, GA 31093-8556

Mailing address

3051 Watson Blvd Ste 525
Warner Robins, GA 31093-8556
Phone (478) 953-4563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210421000466 NY Practitioner - Occupational Therapist in Private Practice 5698928919 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

44 Saint Marks PL
New York, NY 10003-8118
Phone (212) 529-5966

552 6TH Ave
New York, NY 10011-2010
Phone (212) 741-9288

Merit-based Incentive Payment System (MIPS)

Final score
77.16 of 100Reported as group
Quality
70
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017530NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Occupational Therapist CurrentSince Apr 12, 2021 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Occupational Therapist Current Accepting new patients
Professional Occupational & Physical Therapy, PLLC Occupational Therapist CurrentSince Apr 12, 2021 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Occupational Therapist CurrentSince Dec 1, 2023 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Occupational Therapist CurrentSince Dec 1, 2023 Accepting new patients

Locations

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

3 Huntington Quadrangle
Ste 103N
Melville, NY 11747
Phone (516) 474-2816

576 Broadhollow Rd
Melville, NY 11747

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

2 Overhill Rd
Ste 330
Scarsdale, NY 10583
Phone (914) 725-1800

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1033455027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 WATSON BLVD STE 525",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310938556",
            "telephone_number": "478-953-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 WATSON BLVD STE 525",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310938556",
            "telephone_number": "478-953-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "JEFFREY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-19",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC012643",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "DE",
            "license": "U1-0001457",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT006093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.