Individual provider Active NPI

Lauren Anne Wong, PA-C

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1154736932
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
028267 Issued in NY
Practice address
63 Shaker Rd Ste 201
Albany, NY 12204-1030
Phone
(518) 471-3636
Fax
(518) 471-3668
NPI assigned
Jun 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA5040 MA
Physician Assistant 363A00000X 028267 NY Primary

Addresses

Primary practice location

63 Shaker Rd Ste 201
Albany, NY 12204-1030

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other practice location 1

855 Route 146 Ste 150
Clifton Park, NY 12065-3874
Phone (518) 471-3636

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221006000573 NY Practitioner - Physician Assistant 9436370830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St. Peter'S Health Partners Medical Associates, P.C.Group PAC ID 6103061189, 480 clinicians

Practice addresses (Care Compare)

2 New Hampshire Ave
Troy, NY 12180-1764
Phone (518) 525-8220

63 Albany Shaker Rd
Suite 102
Albany, NY 12204-1030
Phone (518) 429-2561

63 Shaker Rd
Albany, NY 12204-1030

Hospital & facility affiliations

  • St Peter'S Hospital Hospital, Albany, NY, CCN 330057
  • Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Health Partners Medical Associates, P.C. Physician Assistant CurrentSince Sep 19, 2022 Accepting new patients
Family Practice Group, P.C. Past Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. Physician Assistant Past Accepting new patients

Locations

63 Shaker Rd
Ste 201
Albany, NY 12204
Phone (518) 446-1850

855 Route 146
Ste 150
Clifton Park, NY 12065
Phone (518) 292-6200

855 Route 146
Bldg B150
Clifton Park, NY 12065

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

Interoperability endpoints

  • Direct secure messaging: lauren.wong.1@6240.direct.athenahealth.com
  • Direct secure messaging: lwong2092703@direct.trinity-health.org

Organizations & group practices 3

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 2

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": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1154736932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 SHAKER RD STE 201",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122041030",
            "telephone_number": "518-471-3636",
            "fax_number": "518-471-3668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "855 Route 146 Ste 150",
            "address_purpose": "LOCATION",
            "city": "Clifton Park",
            "state": "NY",
            "postal_code": "120653874",
            "country_code": "US",
            "telephone_number": "518-471-3636",
            "fax_number": "518-471-3668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "LAUREN",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA5040",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "St. Peter's Health Partners Medical Associates, P.C.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "63 Shaker Rd Ste 201",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122041030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.