Individual provider Active NPI

Lee Lee Wong, M.D.

  • Obstetrics & Gynecology Physician
  • Baltimore, MD
National Provider Identifier
1336407329
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A142938 Issued in CA
Practice address
9000 Franklin Square Dr
Department of OB/GYN
Baltimore, MD 21237-3901
Phone
(443) 777-8257
NPI assigned
Apr 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A142938 CA Primary

Addresses

Primary practice location

9000 Franklin Square Dr
Department of OB/GYN
Baltimore, MD 21237-3901

Mailing address

5820 Owens Dr
Pleasanton, CA 94588-3900
Phone (707) 258-2500

Other practice location 1

1675 Permanente Way
Napa, CA 94558-3338
Phone (707) 258-2500

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

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
I20161121001294 CA Practitioner - Obstetrics/Gynecology 9638458300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

975 Sereno Dr
Vallejo, CA 94589-2441
Phone (707) 651-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
142938CAMDMarriage & Family Therapist
A142938CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Obstetrics & Gynecology CurrentSince Oct 11, 2016 Accepting new patients
Permanente Medical Group Inc Obstetrics & Gynecology Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 11, 2016 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

3285 Claremont Way
Napa, CA 94558
Phone (707) 226-5531

1675 Permanente Way
Napa, CA 94558
Phone (707) 258-2076

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1336407329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 OWENS DR",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883900",
            "telephone_number": "707-258-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 FRANKLIN SQUARE DR",
            "address_2": "DEPARTMENT OF OB/GYN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373901",
            "telephone_number": "443-777-8257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1675 Permanente Way",
            "address_purpose": "LOCATION",
            "city": "Napa",
            "state": "CA",
            "postal_code": "945583338",
            "country_code": "US",
            "telephone_number": "707-258-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "LEE",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-26",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A142938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3285 Claremont Way",
            "city": "Napa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945583313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.