Advanced Gastroenterology Practice PLLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

223587 Issued in NY

Legal business name

ADVANCED GASTROENTEROLOGY PRACTICE PLLC

Practice address

77 Bowery
#701
New York, NY 10002-4915

Phone

(212) 775-8388

Fax

(212) 775-8383

NPI assigned

Feb 17, 2011

Last updated

Aug 20, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Timothy Wong, M.D.NPI 1275731739

Title

Owner

Phone

(212) 775-8388

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timothy Wong, M.D.

  • Gastroenterology Physician
  • New York, NY
  • NPI 1275731739
  Medicare reassignment Care Compare group NPD Authorized official
• Qiusheng Si, M.D., PH.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • White Plains, NY
  • NPI 1821213265
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787184000000",
    "number": "1184921728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 BOWERY",
            "address_2": "#701",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024915",
            "telephone_number": "212-775-8388",
            "fax_number": "212-775-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 BOWERY",
            "address_2": "#701",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024915",
            "telephone_number": "212-775-8388",
            "fax_number": "212-775-8383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Jericho Tpke Ste 200",
            "address_purpose": "LOCATION",
            "city": "Syosset",
            "state": "NY",
            "postal_code": "117914501",
            "country_code": "US",
            "telephone_number": "212-775-8388",
            "fax_number": "212-775-8383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED GASTROENTEROLOGY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-17",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-775-8388",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "223587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in New York, NY
• Providers in New York, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.