Individual provider Active NPI

Andrew Albert Wong

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1104411644
Registry record updated Mar 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
025446 Issued in NY
Practice address
2579 Ocean Ave FL 3
Brooklyn, NY 11229-4552
Phone
(646) 780-0926
NPI assigned
Mar 6, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 025446 NY Primary

Addresses

Primary practice location

2579 Ocean Ave FL 3
Brooklyn, NY 11229-4552

Mailing address

5412 253Rd St
Little Neck, NY 11362-1805
Phone (718) 423-3925

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210310001399 NY Practitioner - Occupational Therapist in Private Practice 1254747686 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6633 Yellowstone Blvd
Apt 3G
Forest Hills, NY 11375-2503
Phone (631) 275-8288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York Physical and Occupational Therapy Services, PLLC Occupational Therapist CurrentSince Mar 8, 2021 Accepting new patients
Forward Function Occupational Therapy and Physical Therapy P.L.L.C. Occupational Therapist CurrentSince Mar 15, 2021 Accepting new patients

Locations

2579 Ocean Ave
Fl 3
Brooklyn, NY 11229
Phone (646) 780-0925

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": "1614988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614988800000",
    "number": "1104411644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5412 253RD ST",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113621805",
            "telephone_number": "718-423-3925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2579 OCEAN AVE FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294552",
            "telephone_number": "646-780-0926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "ANDREW",
        "middle_name": "ALBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-06",
        "last_updated": "2021-03-06",
        "certification_date": "2021-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "025446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2021; 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.