Individual provider Active NPI

Ryan Christopher Wong, M.D.

  • Nephrology Physician
  • Tucson, AZ
National Provider Identifier
1174910053
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
56129 Issued in AZ
Practice address
3838 N Campbell Ave
Tucson, AZ 85719-1454
Phone
(520) 694-8888
Fax
(520) 694-0127
NPI assigned
Apr 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R74943 AZ
Nephrology Physician 207RN0300X MD60951441 WA
Nephrology Physician 207RN0300X 56129 AZ Primary

Addresses

Primary practice location

3838 N Campbell Ave
Tucson, AZ 85719-1454

Mailing address

1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone (520) 694-0111

Other practice location 1

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 543-2346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20210520003149 AZ Practitioner - Nephrology 4385965011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Arizona College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

3838 N Campbell Ave
BLDG 1
Tucson, AZ 85719-1454
Phone (520) 694-2873

Hospital & facility affiliations

  • 032616 Desert Dialysis Sahuarita (Dci) Dialysis facility, Sahuarita, AZ, CCN 032616
  • Banner - University Medical Center Tucson Campus Hospital, Tucson, AZ, CCN 030064
  • Banner-University Medical Center South Campus Hospital, Tucson, AZ, CCN 030111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R74943AZMDInternal Medicine Physician

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.

Hospital & facility affiliations 4

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": "1429315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1174910053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194330",
            "telephone_number": "520-694-0111",
            "fax_number": "520-694-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857191454",
            "telephone_number": "520-694-8888",
            "fax_number": "520-694-0127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1959 NE Pacific St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98195",
            "country_code": "US",
            "telephone_number": "206-543-2346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "RYAN",
        "middle_name": "CHRISTOPHER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-18",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R74943",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD60951441",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": "56129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.