Individual provider Active NPI

Peter J Wong, M.D.

  • Ophthalmology Physician
  • Rockville Centre, NY
National Provider Identifier
1215931670
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
193409 Issued in NY
Practice address
2000 N Village Ave
Ste 402
Rockville Centre, NY 11570-1001
Phone
(516) 766-2519
Fax
(516) 766-3714
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X 193409 NY
Ophthalmology Physician 207W00000X 193409 NY Primary

Addresses

Primary practice location

2000 N Village Ave
Ste 402
Rockville Centre, NY 11570-1001

Mailing address

825 E Gate Blvd Ste 111
Garden City, NY 11530-2136
Phone (516) 804-5200

Other identifiers 1

IdentifierTypeStateIssuer
01465232MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051219000057 NY Practitioner - Ophthalmology 8820019862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
State University of New York Downstate Medical Center, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2000 N Village Ave
Rockville Centre, NY 11570-1078
Phone (516) 766-2519

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision250
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
193409NYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmic Consultants of Long Island Ophthalmology CurrentSince Nov 1, 2005 Accepting new patients
Ophthalmic Consultants of Long Island Ophthalmology CurrentSince Nov 1, 2005 Accepting new patients
Long Island Eye Surgical Care, PC Ophthalmology Past Accepting new patients

Locations

4 Technology Dr
Ste 150
East Setauket, NY 11733
Phone (631) 941-1400

825 E Gate Blvd
Ste 111
Garden City, NY 11530
Phone (516) 804-5200

711 Stewart Ave
Ste 160
Garden City, NY 11530
Phone (516) 500-4200

755 Park Ave
Ste 1
Huntington, NY 11743

3742 73rd St
Jackson Hts, NY 11372
Phone (718) 426-3739

649 Broadway
Massapequa, NY 11758
Phone (516) 798-1411

2860 Long Beach Rd
Oceanside, NY 11572
Phone (516) 593-7709

2000 N Village Ave
Ste 402
Rockville Ctr, NY 11570
Phone (516) 766-2519

2000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1777

2000 N Village Ave
#13202
Rockville Ctr, NY 11570
Phone (516) 766-2519

865 Merrick Ave
Ste 80N
Westbury, NY 11590
Phone (516) 804-5200

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: peter.wong.p1@direct.ocli.nextgenshare.com

Organizations & group practices 3

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1215931670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E GATE BLVD STE 111",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302136",
            "telephone_number": "516-804-5200",
            "fax_number": "516-240-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N VILLAGE AVE",
            "address_2": "STE 402",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115701001",
            "telephone_number": "516-766-2519",
            "fax_number": "516-766-3714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "PETER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "193409",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "193409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01465232",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.