Individual provider Active NPI

Elliot Wong, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1225084965
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD428421 Issued in PA
Practice address
2601 Holme Ave
Philadelphia, PA 19152-2007
Phone
(215) 335-6150
Fax
(215) 335-1832
NPI assigned
May 25, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD428421 PA Primary

Addresses

Primary practice location

2601 Holme Ave
Philadelphia, PA 19152-2007

Mailing address

2188 Winding Way
Broomall, PA 19008-2837
Phone (484) 574-5116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20060915000294 PA Practitioner - Emergency Medicine 5193720613 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD428421PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Emergency Med Associates LLC Emergency Medicine CurrentSince Oct 19, 2010 Accepting new patients

Locations

56 W Main St
Ste 305
Christiana, DE 19702

1068 W Baltimore Pike
Media, PA 19063
Phone (610) 566-9400

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Organizations & group practices 1

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1225084965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2188 WINDING WAY",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190082837",
            "telephone_number": "484-574-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 HOLME AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522007",
            "telephone_number": "215-335-6150",
            "fax_number": "215-335-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "ELLIOT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD428421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.