Individual provider Active NPI

Anna Rae Banez Ong, M.D.

  • Internal Medicine Physician
  • Olympia, WA
National Provider Identifier
1164692539
Registry record updated Mar 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60328767 Issued in WA
Practice address
413 Lilly Rd NE
Olympia, WA 98506-5133
Phone
(360) 493-4069
NPI assigned
Mar 3, 2008
Last updated
Mar 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X MD60328767 WA Primary

Addresses

Primary practice location

413 Lilly Rd NE
Olympia, WA 98506-5133

Mailing address

PO Box 3360
Yale New Haven Hospital
Portland, OR 97208-3360
Phone (866) 747-2455

Other identifiers 1

IdentifierTypeStateIssuer
MD60328767OtherWASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20130419000340 WA Practitioner - Internal Medicine 5890828545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Mercer University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 493-4083

525 Lilly Rd NE
Olympia, WA 98506-5101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60328767WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince May 5, 2013 Accepting new patients
Providence Health & Services Washington Past Accepting new patients

Locations

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363651200000",
    "number": "1164692539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "address_2": "YALE NEW HAVEN HOSPITAL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065133",
            "telephone_number": "360-493-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONG",
        "first_name": "ANNA RAE",
        "middle_name": "BANEZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2013-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60328767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD60328767",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.