Active NPI
Brian William Wong, PT
- Orthopedic Physical Therapist
- Tustin, CA
National Provider Identifier
1255534418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT13998
- Practice address
- 2492 Walnut Ave Ste 140
Tustin, CA 92780-6953 - Phone
- (714) 544-2188
- NPI assigned
- Jun 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT13998 | CA | |
| Sports Physical Therapist | 2251S0007X | PT13998 | CA | |
| Orthopedic Physical Therapist | 2251X0800X | PT13998 | CA | Primary |
Addresses
Primary practice location
2492 Walnut Ave Ste 140
Tustin, CA 92780-6953
Mailing address
2492 Walnut Ave Ste 140
Tustin, CA 92780-6953
Phone (714) 544-2188
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT13998 | Other | CA | PT LICENSE# |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- University of California, San Francisco School of Medicine, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2492 Walnut Ave
Tustin, CA 92780-6953
Phone (714) 544-2188
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT13998 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State-of-the-Art Physical Therapy, Inc. | Physical Therapist | Current | Accepting new patients |
| Pacific Spine & Sports, Inc. | Past | Accepting new patients |
Locations
2492 Walnut Ave
Ste 140
Tustin, CA 92780
Phone (714) 544-2188
Organizations & group practices 2
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.
-
- Physical Therapist
- Tustin, CA
- NPI 1437179959
-
- Chiropractor
- Irvine, CA
- NPI 1104944024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1255534418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2492 WALNUT AVE STE 140",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927806953",
"telephone_number": "714-544-2188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2492 WALNUT AVE STE 140",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927806953",
"telephone_number": "714-544-2188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "BRIAN",
"middle_name": "WILLIAM",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-06",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT13998",
"primary": false
},
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "CA",
"license": "PT13998",
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": "PT13998",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE#",
"identifier": "PT13998",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.