Individual provider Active NPI

Trevor S Wong, PT,DPT

  • Physical Therapist
  • Stony Brook, NY
National Provider Identifier
1184614935
Registry record updated Feb 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
026809-1 Issued in NY
Practice address
2500 Route 347
Suite 8D
Stony Brook, NY 11790-2555
Phone
(631) 828-5761
Fax
(631) 828-5761
NPI assigned
Oct 24, 2005
Last updated
Feb 17, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2009

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 026809-1 NY Primary

Addresses

Primary practice location

2500 Route 347
Suite 8D
Stony Brook, NY 11790-2555

Mailing address

2500 Route 347
Suite 8D
Stony Brook, NY 11790-2555
Phone (631) 828-5761

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
026809NYMDPharmacist
026809-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Twentyseveneastphysiotherapy PC CurrentSince Feb 16, 2020 Accepting new patients
Hamptons Physical Therapy, PC Physical Therapist CurrentSince Oct 1, 2012 Accepting new patients
Bernard Finnerty D/B/a Hampton Physical Therapy Physical Therapist Past Accepting new patients
Three Village Physical Therapy PLLC Physical Therapist Past Accepting new patients
Kah Premium Physical Therapy P.C. Physical Therapist Past Accepting new patients

Locations

34 Bay St
Ste 206
Sag Harbor, NY 11963
Phone (631) 919-5189

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1184614935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 ROUTE 347",
            "address_2": "SUITE 8D",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902555",
            "telephone_number": "631-828-5761",
            "fax_number": "631-828-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ROUTE 347",
            "address_2": "SUITE 8D",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902555",
            "telephone_number": "631-828-5761",
            "fax_number": "631-828-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "TREVOR",
        "middle_name": "S",
        "credential": "PT,DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026809-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; 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.