Selena Constance Wong, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

33549 Issued in CA

Practice address

855 W Foothill Blvd
Monrovia, CA 91016-1938

Phone

(626) 358-1080

Fax

(626) 358-0548

NPI assigned

Jul 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Selena Constance Chu Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of California - School of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Azul Vision IncGroup PAC ID 2264851740, 49 clinicians

California Eye Specialists Medical Group IncGroup PAC ID 6800793381, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: selena.wong.p1@direct.atlantiseyecare.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Azul Vision Inc.

  • Ophthalmology Physician
  • Pasadena, CA
  • NPI 1285247528

  Optometrist

  Medicare reassignment Care Compare group NPD
• California Eye Specialists Medical Group, Inc

  • Specialist
  • Pasadena, CA
  • NPI 1699713099
  Medicare reassignment Care Compare group NPD
• Levine, Robert E. MD, a Medical Corporation

  • Ophthalmology Physician
  • Beverly Hills, CA
  • NPI 1245534254
  NPD
• Progressive Vision Institute of Philadelphia, PC

  • Ophthalmology Physician
  • Philadelphia, PA
  • NPI 1205878915
  NPD
• Eyecare Specialists Medical Group, Inc

  • Ophthalmology Physician
  • Anaheim, CA
  • NPI 1437181930

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1164787628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14726 RAMONA AVE STE 203",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917105730",
            "telephone_number": "626-305-9100",
            "fax_number": "626-305-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 W FOOTHILL BLVD",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910161938",
            "telephone_number": "626-358-1080",
            "fax_number": "626-358-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "SELENA",
        "middle_name": "CONSTANCE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002662",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102733683",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164787628",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "OEG002662",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SELENA",
            "last_name": "CHU",
            "middle_name": "CONSTANCE",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristine Wong, MS, RDN
• Lip Kok Wong
• Miles Wong, PHARMD
• Nadia Wong
• Olivia Wong
• Tiffany Wong, NP
• Tiffany Wong
• Wai Yin Winnie Wong
• Willa Wai-Lai Wong, O.D.
• Dana Wood

• Optometrist in Monrovia, CA
• Providers in Monrovia, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.