Individual provider Active NPI

Tin-Cheu Wong, M.D.

  • Ophthalmology Physician
  • Monterey Park, CA
National Provider Identifier
1083825624
Registry record updated Jan 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G56514 Issued in CA
Practice address
420 N Garfield Ave Ste 208
Monterey Park, CA 91754-1206
Phone
(626) 572-3937
Fax
(626) 571-8819
NPI assigned
May 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G56514 CA Primary

Addresses

Primary practice location

420 N Garfield Ave Ste 208
Monterey Park, CA 91754-1206

Mailing address

420 N Garfield Ave Ste 208
Monterey Park, CA 91754-1206
Phone (626) 572-3937

Other identifiers 1

IdentifierTypeStateIssuer
00G565140MedicaidCA

Other names 1

  • Dr. Kevin T. C. Wong Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120424000703 CA Practitioner - Ophthalmology 9739092479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Medical University of South Carolina College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

420 N Garfield Ave
Monterey Park, CA 91754-1206
Phone (626) 572-3937

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G56514CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Institute of Los Angeles Ophthalmology CurrentSince Oct 9, 1989 Accepting new patients

Locations

420 N Garfield Ave
Ste 208
Monterey Park, CA 91754
Phone (626) 572-3937

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200096000000",
    "number": "1083825624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N GARFIELD AVE STE 208",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541206",
            "telephone_number": "626-572-3937",
            "fax_number": "626-571-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N GARFIELD AVE STE 208",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541206",
            "telephone_number": "626-572-3937",
            "fax_number": "626-571-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "TIN-CHEU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2008-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G56514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G565140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEVIN",
            "last_name": "WONG",
            "middle_name": "T. C.",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Monterey Park, CA

Sources for this page

Verify at the official NPI Registry.