Organization Active NPI

Dr. Wong & Associates, LTD.

  • Optometrist
  • Danbury, CT
National Provider Identifier
1114078169
Registry record updated Aug 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
CT002529 Issued in CT
Legal business name
DR. WONG & ASSOCIATES, LTD.
Practice address
7 Backus Ave Ste 250
Danbury, CT 06810-7493
Phone
(203) 743-9897
Fax
(203) 743-6419
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2007

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

Authorized official

Name
Dr. Ivan Wong, O.D.NPI 1023170073
Title
President
Phone
(203) 743-9897

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X CT002529 CT Primary
Corneal and Contact Management OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WC0802X CT002529 CT

Addresses

Primary practice location

7 Backus Ave Ste 250
Danbury, CT 06810-7493

Mailing address

7 Backus Ave Ste 250
Danbury, CT 06810-7493
Phone (203) 743-9897

Other identifiers 1

IdentifierTypeStateIssuer
C03256OtherCTMEDICARE LEGACY BILLING

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050104000044 CT Part B Supplier - Clinic/Group Practice 4082662374 Receives reassigned benefits from 6 practitioners
Practice locations: Danbury, CT

National Provider Directory

National Provider Directory

Locations

18 Mill Plain Rd
Danbury, CT 06811
Phone (203) 743-9897

7 Backus Ave
Ste 250
Danbury, CT 06810
Phone (203) 743-9897

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1114078169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BACKUS AVE STE 250",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107493",
            "telephone_number": "203-743-9897",
            "fax_number": "203-743-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 BACKUS AVE STE 250",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107493",
            "telephone_number": "203-743-9897",
            "fax_number": "203-743-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. WONG & ASSOCIATES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-743-9897",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CT",
            "license": "CT002529",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CT",
            "license": "CT002529",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LEGACY BILLING",
            "identifier": "C03256",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.