Individual provider Active NPI

Lim W Wong, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1144264763
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD062392L Issued in PA
Practice address
833 Chestnut St
Suite 701
Philadelphia, PA 19107-4409
Phone
(215) 955-0735
Fax
(215) 503-9239
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD062392L PA Primary

Addresses

Primary practice location

833 Chestnut St
Suite 701
Philadelphia, PA 19107-4409

Mailing address

833 Chestnut St
Suite 701
Philadelphia, PA 19107-4409
Phone (215) 955-0735

Other identifiers 1

IdentifierTypeStateIssuer
0016472000002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100602000613 PA Practitioner - Internal Medicine 5890885982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Icahn School of Medicine at Mount Sinai, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

833 Chestnut St E
7TH FLR Suite 700
Philadelphia, PA 19107-5102
Phone (215) 503-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians Internal Medicine CurrentSince Jan 9, 2010 Accepting new patients
Thomas Jefferson University Hospitals Inc Past Accepting new patients

Locations

833 Chestnut St
Ste 700
Philadelphia, PA 19107
Phone (215) 503-3000

833 Chestnut St
Ste 701
Philadelphia, PA 19107
Phone (215) 955-0735

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

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.

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428969600000",
    "number": "1144264763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST",
            "address_2": "SUITE 701",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074409",
            "telephone_number": "215-955-0735",
            "fax_number": "215-503-9239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST",
            "address_2": "SUITE 701",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074409",
            "telephone_number": "215-955-0735",
            "fax_number": "215-503-9239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "LIM",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2015-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD062392L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016472000002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.