Active NPI
Nathan A Wong, MD
- Family Medicine Physician
- Waipahu, HI
National Provider Identifier
1114073277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD-2899
- Practice address
- 94-1480 Moaniani St
Waipahu, HI 96797-4632 - Phone
- (808) 432-3100
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD-2899 | HI | Primary |
Addresses
Primary practice location
94-1480 Moaniani St
Waipahu, HI 96797-4632
Mailing address
94-1480 Moaniani St
Waipahu, HI 96797-4632
Phone (808) 432-3100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040919-02 | Medicaid | HI |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-2899 | HI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192752000000",
"number": "1114073277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94-1480 MOANIANI ST",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967974632",
"telephone_number": "808-432-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94-1480 MOANIANI ST",
"city": "WAIPAHU",
"state": "HI",
"postal_code": "967974632",
"telephone_number": "808-432-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "NATHAN",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2007-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "HI",
"license": "MD-2899",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "040919-02",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waipahu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.