Individual provider Active NPI

Amanda Wong, PHARMD, RPH

  • Pharmacist
  • Dorchester, MA
National Provider Identifier
1093319717
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH238953 Issued in MA
Practice address
451 Washington St
Dorchester, MA 02124-1138
Phone
(617) 740-0611
NPI assigned
Nov 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH238953 MA Primary

Addresses

Primary practice location

451 Washington St
Dorchester, MA 02124-1138

Mailing address

451 Washington St
Dorchester, MA 02124-1138
Phone (617) 740-0611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH238953MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Pharmacy Inc PastSince Nov 29, 2020 Accepting new patients
CVS Pharmacy Inc PastSince Nov 29, 2020 Accepting new patients

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": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1093319717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 WASHINGTON ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021241138",
            "telephone_number": "617-740-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 WASHINGTON ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021241138",
            "telephone_number": "617-740-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "AMANDA",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH238953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.