Individual provider Active NPI

Philip Wong Wong, MD

  • Pulmonary Disease Physician
  • Sebring, FL
National Provider Identifier
1306800727
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME99701 Issued in FL
Practice address
4325 Sun N Lake Blvd Ste 102
Sebring, FL 33872-2171
Phone
(863) 382-1663
Fax
(863) 386-0162
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2018

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 10496 ND
Pulmonary Disease Physician 207RP1001X M6468 TX
Pulmonary Disease Physician 207RP1001X 17471 MS
Pulmonary Disease Physician 207RP1001X 238898 NY
Pulmonary Disease Physician 207RP1001X C52602 CA
Pulmonary Disease Physician 207RP1001X 11841 NV
Pulmonary Disease Physician 207RP1001X ME99701 FL Primary

Addresses

Primary practice location

4325 Sun N Lake Blvd Ste 102
Sebring, FL 33872-2171

Mailing address

4325 Sun N Lake Blvd Ste 102
Sebring, FL 33872-2171
Phone (863) 382-1663

Other practice location 1

4421 Sun N Lake Blvd
Suite B
Sebring, FL 33872-2172
Phone (863) 382-1663

Other identifiers 2

IdentifierTypeStateIssuer
279273700MedicaidFL
0125040MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20071208000011 FL Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 9638102916 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Saint Louis University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventist Health System-Sunbelt IncGroup PAC ID 0749232445, shared by 8 NPIs, 100 clinicians

Practice addresses (Care Compare)

533 Carlton St
Wauchula, FL 33873-3407
Phone (863) 773-3101

Hospital & facility affiliations

  • Adventhealth Sebring Hospital, Sebring, FL, CCN 100109
  • Adventhealth Heart of Florida Hospital, Davenport, FL, CCN 100137
  • Adventhealth Wauchula Hospital, Wauchula, FL, CCN 101300

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C52602CAMDPulmonary Disease Physician
ME99701FLMDPulmonary Disease Physician
17471MSMDPulmonary Disease Physician
10496NDMDPulmonary Disease Physician
11841NVMDPulmonary Disease Physician
238898NYMDPulmonary Disease Physician
M6468TXMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System-Sunbelt Inc CurrentSince Jun 1, 2008 Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Jun 15, 2017 Accepting new patients
Florida Hospital Medical Group Inc Past Accepting new patients
Clarksdale Hma Physican Management, LLC Past Accepting new patients

Locations

1210 US Highway 27 N
Lake Placid, FL 33852
Phone (863) 465-3777

4421 Sun N Lake Blvd
Ste B
Sebring, FL 33872
Phone (863) 382-9600

4325 Sun N Lake Blvd
Ste 102
Sebring, FL 33872
Phone (863) 314-8600

522 Carlton St
Wauchula, FL 33873
Phone (863) 773-0975

533 Carlton St
Wauchula, FL 33873
Phone (863) 767-8256

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: pwong622092@adventhealth.direct-ci.com

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 3

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1306800727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 SUN N LAKE BLVD STE 102",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722171",
            "telephone_number": "863-382-1663",
            "fax_number": "863-386-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 SUN N LAKE BLVD STE 102",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722171",
            "telephone_number": "863-382-1663",
            "fax_number": "863-386-0162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4421 Sun N Lake Blvd",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Sebring",
            "state": "FL",
            "postal_code": "338722172",
            "country_code": "US",
            "telephone_number": "863-382-1663",
            "fax_number": "863-386-0162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "PHILIP",
        "middle_name": "WONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "ND",
            "license": "10496",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "M6468",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MS",
            "license": "17471",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "238898",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "C52602",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NV",
            "license": "11841",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME99701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279273700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0125040",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

Verify at the official NPI Registry.