Walter C. Fong, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00025056 Issued in WA

Practice address

10416 5TH Ave NE
Seattle, WA 98125-7402

Phone

(206) 517-6700

NPI assigned

Oct 14, 2005

Last updated

Jul 23, 2012By 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 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Internal Medicine

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

International Community Health ServicesGroup PAC ID 5799695672, 95 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wfong1186635@wm.providencedirect.org

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.

• International Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1376659151

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• International Community Health Services

  • Optometrist
  • Seattle, WA
  • NPI 1376083741
  NPD
• International Community Health Services

  dba ICHS at Sound Auburn

  • Federally Qualified Health Center (FQHC)
  • Auburn, WA
  • NPI 1831910439
  NPD
• Pacmed Clinics

  dba PacMed Clinics - Sleep Center

  • Sleep Disorder Diagnostic Clinic/Center
  • Seattle, WA
  • NPI 1922214212
  NPD (past)

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1285623033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10416 5TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981257402",
            "telephone_number": "206-517-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10416 5TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981257402",
            "telephone_number": "206-517-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "WALTER",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00025056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8305351",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Geoffrey Fong, ARNP
• Kelly Fong
• Lawrence Fong, MD
• Mei-Ji Fong
• Rosemary Fong
• Giuiseppe Allan Fonseca Badillo, MD
• Patricia Fonseca, LPN
• Andrew Duffy Fontana, LMHC
• Robert Matthew Fontana, MFT
• Fevee Fontejon

• Internal Medicine Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.