Individual provider Active NPI

Tony Wong, O.D.

  • Optometrist
  • Redmond, WA
National Provider Identifier
1063447498
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
WA3422TX Issued in WA
Practice address
15350 Bel Red Rd Unit 130
Redmond, WA 98052-7366
Phone
(425) 562-2015
Fax
(425) 562-2010
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X WA3422TX WA Primary

Addresses

Primary practice location

15350 Bel Red Rd Unit 130
Redmond, WA 98052-7366

Mailing address

15350 Bel Red Rd Unit 130
Redmond, WA 98052-7366
Phone (425) 562-2015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041012000695 WA Practitioner - Optometry 4486614773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Eye Designs, P.C.Group PAC ID 8628038916, 2 clinicians

Practice addresses (Care Compare)

15230 NE 24TH St
Suite Q
Redmond, WA 98052-5540

15350 Bel Red Rd
Unit 130
Redmond, WA 98052-7366
Phone (425) 562-2015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
WA3422TXWAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Eye Designs, P.C. Optometrist CurrentSince Oct 1, 2004 Accepting new patients
Overlake Eye Designs, P.C. Optometrist Current Accepting new patients

Locations

15230 NE 24th St
Ste Q
Redmond, WA 98052
Phone (425) 562-2015

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1063447498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15350 BEL RED RD UNIT 130",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980527366",
            "telephone_number": "425-562-2015",
            "fax_number": "425-562-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15350 BEL RED RD UNIT 130",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980527366",
            "telephone_number": "425-562-2015",
            "fax_number": "425-562-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "TONY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2023-11-01",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "WA3422TX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

Verify at the official NPI Registry.