Individual provider Active NPI

Megan Ashley Wong, DPT

  • Physical Therapist
  • Berkeley, CA
National Provider Identifier
1174248306
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
302682 Issued in CA
Practice address
2030 Addison St Ste 101
Berkeley, CA 94704-1140
Phone
(510) 644-8031
NPI assigned
Oct 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 302682 CA Primary

Addresses

Primary practice location

2030 Addison St Ste 101
Berkeley, CA 94704-1140

Mailing address

172 Bayview Cir
San Francisco, CA 94124-2286
Phone (415) 370-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
302682CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
G Sports Physical Therapy, Inc. Physical Therapist CurrentSince Oct 16, 2022 Accepting new patients

Locations

2030 Addison St
Ste 101
Berkeley, CA 94704
Phone (510) 644-8031

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1174248306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 BAYVIEW CIR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941242286",
            "telephone_number": "415-370-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 ADDISON ST STE 101",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041140",
            "telephone_number": "510-644-8031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "MEGAN",
        "middle_name": "ASHLEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.