Wilson Shen Wong, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

G39963 Issued in CA

Practice address

300 W Huntington Dr
Arcadia, CA 91007

Phone

(626) 898-8610

NPI assigned

Jan 30, 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Beverly Radiology Medical Group III

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1962457812
  Medicare reassignment NPD
• Kern Radiology Medical Group, Inc

  • Diagnostic Radiology Physician
  • Bakersfield, CA
  • NPI 1700821972
  Medicare reassignment NPD
• Pronet Imaging Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1528099488
  Medicare reassignment NPD
• Radnet Medical Imaging-San Francisco

  • Diagnostic Radiology Physician
  • San Francisco, CA
  • NPI 1548345382
  Medicare reassignment NPD
• San Fernando Valley Interventional Radiology and Imaging Center

  • Vascular-Interventional Technology Radiologic Technologist
  • Encino, CA
  • NPI 1942350889
  Medicare reassignment NPD
• Beverly Radiology Medical Group III

  dba Elite Advanced Imaging

  • Diagnostic Radiology Physician
  • Victorville, CA
  • NPI 1114112372
  NPD
• Beverly Radiology Medical Group III

  • Diagnostic Radiology Physician
  • Victorville, CA
  • NPI 1497941421
  NPD
• Beverly Radiology Medical Group III

  dba Temecula Valley Imaging Ctr--Menifee

  • Diagnostic Radiology Physician
  • Menifee, CA
  • NPI 1649599085
  NPD
• Beverly Radiology Medical Group III

  dba Anaheim Advanced Imaging

  • Diagnostic Radiology Physician
  • Anaheim, CA
  • NPI 1972826774
  NPD
• Kern Radiology Medical Group, Inc

  • Diagnostic Radiology Physician
  • Bakersfield, CA
  • NPI 1720023997
  NPD

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1255302097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1047",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391047",
            "telephone_number": "626-898-8610",
            "fax_number": "626-445-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HUNTINGTON DR",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "91007",
            "telephone_number": "626-898-8610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "612 W Duarte Rd",
            "address_2": "Ste 101",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "CA",
            "postal_code": "910079220",
            "country_code": "US",
            "telephone_number": "626-445-4850",
            "fax_number": "626-445-0482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "WILSON",
        "middle_name": "SHEN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G39963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300058011",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300037247",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kai Y Wong, M.D.
• Lonnie Wong, AUD
• Tiffany Wong
• Timothy Wong, PHARMD
• Timothy Wong, DDS
• Daniel D Wongthavatchai, LCSW
• Courtney Woo, RDN
• Joyce Woo
• Katherine Woodhouse, BCBA
• Woods Medical and Associates

• Diagnostic Radiology Physician in Arcadia, CA
• Providers in Arcadia, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.