NPIMap

Individual provider Active NPI

Lawrence Wong

  • Nephrology Physician
  • Temple Terrace, FL
National Provider Identifier
1295930659
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME99695 Issued in FL
Practice address
12662 Telecom Dr
Temple Terrace, FL 33637-0935
Phone
(813) 910-8708
Fax
(855) 852-7153
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME99695 FL Primary

Addresses

Primary practice location

12662 Telecom Dr
Temple Terrace, FL 33637-0935

Mailing address

12662 Telecom Dr
Temple Terrace, FL 33637-0935
Phone (813) 910-8708

Other identifiers 1

IdentifierTypeStateIssuer
280444100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071114000237 FL Practitioner - NephrologyPractitioner - Internal Medicine 7810085545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Wayne State University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Kidney Physicians LLCGroup PAC ID 4385925650, 167 clinicians

Practice addresses (Care Compare)

12662 Telecom Dr
Temple Terrace, FL 33637-0935
Phone (813) 910-0030

Hospital & facility affiliations

  • DaVita Carrollwood Dialysis Dialysis facility, Tampa, FL, CCN 682520
  • Usrc North Tampa Dialysis Dialysis facility, Tampa, FL, CCN 682587
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127
  • AdventHealth Carrollwood Hospital, Tampa, FL, CCN 100069
  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173

Merit-based Incentive Payment System (MIPS)

Final score
97.77 of 100Reported as individual
Quality
82.34
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Kidney Physicians , LLC Nephrology CurrentSince Oct 11, 2016 Accepting new patients
Tampa General Hospital Current Accepting new patients
Florida Kidney Physicians, LLC Nephrology CurrentSince Oct 11, 2016 Accepting new patients
Gulf Coast Nephrology Associates Nephrology PastSince May 5, 2018 Accepting new patients

Locations

409 Bayshore Blvd
Fl 4
Tampa, FL 33606
Phone (813) 910-8708

3419 N Lakeview Dr
Tampa, FL 33618
Phone (813) 844-7600

4710 N Habana Ave
Ste 107
Tampa, FL 33614
Phone (813) 870-3767

12662 Telecom Dr
Temple Terrace, FL 33637
Phone (813) 910-8708

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15644/brand/1/csg/1/fhir/r4
  • Direct secure messaging: lwong8867@direct.tgh.org
  • Direct secure messaging: lawrence.wong.1@15644.direct.athenahealth.com
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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 8

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1295930659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12662 TELECOM DR",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370935",
            "telephone_number": "813-910-8708",
            "fax_number": "855-852-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12662 TELECOM DR",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370935",
            "telephone_number": "813-910-8708",
            "fax_number": "855-852-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "LAWRENCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME99695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280444100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.