Individual provider Active NPI

Vincent Jih Chong Wong

  • Urology Physician
  • San Bernardino, CA
National Provider Identifier
1316302441
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A195162 Issued in CA
Practice address
489 E 21St St
San Bernardino, CA 92404-4816
Phone
(190) 988-2297
NPI assigned
Dec 16, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X A195162 CA Primary

Addresses

Primary practice location

489 E 21St St
San Bernardino, CA 92404-4816

Mailing address

489 E 21St St
San Bernardino, CA 92404-4816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240927002009 CA Practitioner - Urology 8921539297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Northwestern University Feinberg Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franklin M Chu MD IncGroup PAC ID 7315978632, 7 clinicians

Practice addresses (Care Compare)

489 E 21St St
San Bernardino, CA 92404-4816
Phone (909) 882-2973

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin M Chu MD Inc Single Specialty CurrentSince Sep 1, 2024 Accepting new patients
Dignity Health Medical Foundation Single Specialty Past Accepting new patients

Locations

489 E 21st St
Sn Bernrdno, CA 92404
Phone (909) 882-2973

Interoperability endpoints

  • Direct secure messaging: vincentwong@sburo.allscriptsdirect.net

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.

Hospital & facility affiliations 4

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": "1450224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1316302441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 E 21ST ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 E 21ST ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044816",
            "telephone_number": "190-988-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "VINCENT",
        "middle_name": "JIH CHONG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-16",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "A195162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.