Barry Harvey Wong, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT13997 Issued in CA

Practice address

1710 N Fern St
Orange, CA 92867-4061

Phone

(949) 276-1276

NPI assigned

Jun 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• State-of-the-Art Physical Therapy, Inc.

  • Physical Therapist
  • Tustin, CA
  • NPI 1437179959
  Medicare reassignment NPD

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1144423302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 N FERN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928674061",
            "telephone_number": "949-276-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 N FERN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928674061",
            "telephone_number": "949-276-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "BARRY",
        "middle_name": "HARVEY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT13997",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "PT13997",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT13997",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE#",
            "identifier": "PT13997",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Jisoo Won, MD
• Allan Michael Wong, MD
• Allison Elizabeth Wong, MS, CGC
• Alton Wong
• Anne B Wong, MD
• Brandon John Wong
• Brian Wong, MD
• Christina Wong
• Daphne L Wong, MD
• Ethan Ryan Wong

• Physical Therapist in Orange, CA
• Providers in Orange, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.