Individual provider Active NPI

Calvin Takchun Wong, MD

  • Anesthesiology Physician
  • Olympia, WA
National Provider Identifier
1093923997
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD60305917 Issued in WA
Practice address
3901 Capital Mall Dr SW
Olympia, WA 98502-8654
Phone
(425) 407-1500
NPI assigned
May 21, 2007
Last updated
Dec 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101239158 VA
Anesthesiology Physician 207L00000X MD60305917 WA Primary

Addresses

Primary practice location

3901 Capital Mall Dr SW
Olympia, WA 98502-8654

Mailing address

PO Box 94525
Seattle, WA 98124-6825
Phone (425) 407-1500

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180109001959 WA Practitioner - Anesthesiology 4284707548 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Medical Center Specialty Physicians LLCGroup PAC ID 2567651771, 103 clinicians

Practice addresses (Care Compare)

3900 Capital Mall Dr SW
Olympia, WA 98502-8654
Phone (360) 704-4743

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Anesthesia Associates PLLC Anesthesiology CurrentSince Feb 1, 2018 Accepting new patients
Capital Medical Center Specialty Physicians, LLC CurrentSince Oct 3, 2022 Accepting new patients
Columbia Anesthesia Group P S Anesthesiology CurrentSince Sep 1, 2019 Accepting new patients
Sheridan Healthcare of Washington, PC Anesthesiology PastSince Sep 25, 2019 Accepting new patients
Tahoma Anesthesiology Consultants PS Anesthesiology Past Accepting new patients

Locations

3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743

3901 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 709-6221

3901 Capital Mall Dr SW
Ste B
Olympia, WA 98502
Phone (360) 528-8571

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

Interoperability endpoints

  • Direct secure messaging: cwong421293@direct.peacehealth.org
  • Direct secure messaging: cwong676619@direct.multicare.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1093923997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94525",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981246825",
            "telephone_number": "425-407-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 CAPITAL MALL DR SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028654",
            "telephone_number": "425-407-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "CALVIN",
        "middle_name": "TAKCHUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101239158",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD60305917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.