Samuel J Wong, DO

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

20A5983 Issued in CA

Practice address

2905 Telegraph Ave
Berkeley, CA 94705-2017

Phone

(510) 841-0411

Fax

(510) 204-9086

NPI assigned

Sep 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

East Bay Nephrology Medical Group IncGroup PAC ID 1759377757, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Alameda County Dialysis Dialysis facility, Oakland, CA, CCN 052787
• Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305
• Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: samuel.wong.d1.p72@direct.aac.nextgenshare.com
• Direct secure messaging: swong60805@hisp.ehr.sutterhealth.org
• Direct secure messaging: samuel.wong.1@6134.direct.athenahealth.com

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.

• East Bay Nephrology Medical Group, Inc.

  • Nephrology Physician
  • Vallejo, CA
  • NPI 1184719809
  Medicare reassignment Care Compare group NPD
• Dialysis Access Center a Medical Corporation

  • Nephrology Physician
  • Oakland, CA
  • NPI 1699852327
  Medicare reassignment NPD
• East Bay Nephrology Medical Group, Inc.

  • Nephrology Physician
  • Berkeley, CA
  • NPI 1871699074
  NPD
• Alameda Health System

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1396764353
  NPD (past)
• Alta Bates Summit Medical Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Oakland, CA
  • NPI 1043358542
  NPD (past)
• California Pacific Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)
• Hill Physicians Medical Group - PPO Program

  • Preferred Provider Organization
  • San Ramon, CA
  • NPI 1679011035
  NPD (past)
• Sutter Bay Hospitals

  • Rehabilitation Hospital Unit
  • Oakland, CA
  • NPI 1194171371
  NPD (past)
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Vallejo, CA
  • NPI 1366686248
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1295181477
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Berkeley, CA
  • NPI 1639523004
  Care Compare affiliation

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1215034905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052017",
            "telephone_number": "510-841-4525",
            "fax_number": "510-845-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052017",
            "telephone_number": "510-841-0411",
            "fax_number": "510-204-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "SAMUEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "20A5983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX59830",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390004072",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristina Lynn Wong, PHARMD
• Megan Ashley Wong, DPT
• Michael Wong, OD
• Nelson Onyin Wong, MS
• Pauline Fue Wong, LAC DC
• Shirley Wong, PHARM.D.
• Sik-Lam Wong
• Steven Wong
• Teresa W Wong, RN
• Laurie Elizabeth Wonnell, D.C.

• Nephrology Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; 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.