Individual provider Active NPI

Scott Wong, MD

  • Surgery Physician
  • Maryville, IL
National Provider Identifier
1275604498
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036103837 Issued in IL
Practice address
6810 State Route 162 Ste 100
Maryville, IL 62062-8560
Phone
(618) 288-3616
Fax
(618) 288-3647
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2017031136 MO
Vascular Surgery Physician 2086S0129X 036103837 IL
Surgery Physician 208600000X 036103837 IL Primary

Addresses

Primary practice location

6810 State Route 162 Ste 100
Maryville, IL 62062-8560

Mailing address

6810 State Route 162 Ste 100
Maryville, IL 62062-8560
Phone (618) 288-3616

Other identifiers 1

IdentifierTypeStateIssuer
036103837002MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wongs@andersonmg.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041101000430 IL Practitioner - General Surgery 5991767055 Reassigns benefits to 2 organizations
I20171113001531 MO Practitioner - General Surgery 5991767055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Alabama School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Practice addresses (Care Compare)

6800 State Route 162
Maryville, IL 62062-8500
Phone 6182885711402

6810 State Route 162
Maryville, IL 62062-8501
Phone (618) 288-5711

6812 State Route 162
Maryville, IL 62062-8553

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.76 of 100Reported as group
Quality
54.98
Promoting interoperability
85
Improvement activities
40
Cost
73.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036103837ILMDSurgery Physician
2017031136MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Jul 1, 2022 Accepting new patients
Ahs Il Medical Group LLC CurrentSince Nov 14, 2023 Accepting new patients
SSM Health Care Group Surgery CurrentSince Jul 1, 2022 Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

2100 Madison Ave
Ste 301
Granite City, IL 62040

2044 Madison Ave
Ste 27
Granite City, IL 62040
Phone (618) 451-0700

2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000

3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

3691 Rutger St
Saint Louis, MO 63110
Phone (314) 268-4101

3655 Vista Ave
Saint Louis, MO 63110
Phone (314) 977-5110

1034 S Brentwood Blvd
Ste 550
Saint Louis, MO 63117
Phone (314) 542-3600

Interoperability endpoints

  • Direct secure messaging: swong224120@direct-ehr-ssmhc.com
  • Direct secure messaging: scott.wong.1@28328.direct.athenahealth.com
  • Direct secure messaging: swong@yourcarecommunity.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1275604498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162 STE 100",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628560",
            "telephone_number": "618-288-3616",
            "fax_number": "618-288-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162 STE 100",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628560",
            "telephone_number": "618-288-3616",
            "fax_number": "618-288-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2017031136",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036103837",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036103837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036103837002",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wongs@andersonmg.com",
            "affiliation": "N",
            "address_1": "6810 State Route 162 Ste 100",
            "city": "Maryville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620628560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.