Kenneth Edward Wong, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

11066R Issued in LA

Practice address

102 Twin Oaks Dr
Raceland, LA 70394-2760

Phone

(985) 837-4000

Fax

(985) 537-4074

NPI assigned

Jul 7, 2005

Last updated

Oct 19, 2015By the provider in NPPES

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 LA

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

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiovascular Institute of the South, LLCGroup PAC ID 3779497441, 145 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner St Anne General Hospital Hospital, Raceland, LA, CCN 191324
• Lady of the Sea General Hospital Hospital, Cut Off, LA, CCN 191325
• Thibodaux Regional Medical Center Hospital, Thibodaux, LA, CCN 190004

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cardiovascular Institute of the South, LLC

  • Cardiovascular Disease Physician
  • Houma, LA
  • NPI 1982689113
  Medicare reassignment Care Compare group
• Thibodaux Regional Network Development Corporation

  • Anesthesiology Physician
  • Thibodaux, LA
  • NPI 1285658310
  NPD
• Terrebonne Parish Hospital Service District #1

  dba Terrebonne General Medical Center

  • Anesthesiology Physician
  • Houma, LA
  • NPI 1740248129
  NPD (past)
• Thibodaux Regional Network Development Corporation

  dba Thibodaux Regional Radiology

  • Diagnostic Radiology Physician
  • Thibodaux, LA
  • NPI 1467427336
  NPD (past)

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

• Lafourche Parish Hospital Service District No.1

  dba Lady of the Sea General Hospital

  • Critical Access Hospital
  • Cut Off, LA
  • NPI 1407883341
  Care Compare affiliation
• Ochsner Bayou LLC

  dba Ochsner St. Anne General Hospital

  • Critical Access Hospital
  • Raceland, LA
  • NPI 1396761805
  Care Compare affiliation
• Thibodaux Regional Health System Inc

  • General Acute Care Hospital
  • Thibodaux, LA
  • NPI 1902465065
  Care Compare affiliation

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1215935986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4176",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703614176",
            "telephone_number": "985-876-0300",
            "fax_number": "985-872-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 TWIN OAKS DR",
            "city": "RACELAND",
            "state": "LA",
            "postal_code": "703942760",
            "telephone_number": "985-837-4000",
            "fax_number": "985-537-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KENNETH",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "11066R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "060048455",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1663522",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lamar E Waguespack II, DDS
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0761)
• Kelsey Morris Williams, NP-C
• Cheryl Marie Wilson, R.N.
• Paula M Wilt, MD
• Wrap Around Services of Raceland LLC
• Curtis John Zeringue, DDS
• Zoom Transports LLC

• Cardiovascular Disease Physician in Raceland, LA
• Providers in Raceland, LA by specialty
• Cardiovascular Disease Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.