Individual provider Active NPI

Christopher Yb Wong, MPT

  • Physical Therapist
  • Kirkland, WA
National Provider Identifier
1073685103
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6203 Issued in WA
Practice address
14050 Juanita Dr. N.E.
Suite B
Kirkland, WA 98034
Phone
(425) 821-3775
Fax
(425) 821-1986
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6203 WA Primary

Addresses

Primary practice location

14050 Juanita Dr. N.E.
Suite B
Kirkland, WA 98034

Mailing address

14050 Juanita Dr. N.E.
Suite B
Kirkland, WA 98034
Phone (425) 821-3775

Other identifiers 3

IdentifierTypeStateIssuer
137931OtherINDIVID L & I
6489W0OtherINDIVID REGENCE
7101744MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050223000521 WA Practitioner - Physical Therapist in Private Practice 0143271429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inglewood Physical Therapy PSGroup PAC ID 2264483544, 3 clinicians

Practice addresses (Care Compare)

14050 Juanita Dr NE
Suite B
Kirkland, WA 98034-9708
Phone (425) 821-3775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6203WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Inglewood Physical Therapy PS Physical Therapist CurrentSince Jan 28, 2005 Accepting new patients

Locations

14050 Juanita Dr NE
Ste B
Kirkland, WA 98034
Phone (425) 821-3775

Organizations & group practices 1

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1073685103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14050 JUANITA DR. N.E.",
            "address_2": "SUITE B",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-821-3775",
            "fax_number": "425-821-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14050 JUANITA DR. N.E.",
            "address_2": "SUITE B",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-821-3775",
            "fax_number": "425-821-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "CHRISTOPHER",
        "middle_name": "YB",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "6203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVID L & I",
            "identifier": "137931",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVID REGENCE",
            "identifier": "6489W0",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101744",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.