Michelle Ann Wong, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

52720 Issued in CA

Practice address

200 Mission Blvd
1St Floor
Jackson, CA 95642-2564

Phone

(209) 223-7555

NPI assigned

Aug 10, 2015

Last updated

Oct 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Michelle Ann Ausilio Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dispatchhealth-Ca PCGroup PAC ID 4789086455, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michelle.wong.1@13869.direct.athenahealth.com
• Direct secure messaging: michelle.wong.1@20515.direct.athenahealth.com
• Direct secure messaging: mwong310980@hisp.ehr.sutterhealth.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.

• Dispatchhealth-Ca, PC

  • Emergency Medicine Physician
  • Tustin, CA
  • NPI 1639752553
  Medicare reassignment Care Compare group
• Vituity - Urgent Care Services PC

  dba Jovive Urgent Care

  • Urgent Care Clinic/Center
  • Cameron Park, CA
  • NPI 1013588250
  Medicare reassignment NPD
• Emergency Medicine Physician Partners of El Dorado County, Inc

  • Emergency Medicine Physician
  • Placerville, CA
  • NPI 1619278660
  Medicare reassignment
• Vallejo Emergency Physicians Medical Group Inc.

  • Emergency Medicine Physician
  • Vallejo, CA
  • NPI 1083916373
  Medicare reassignment
• Professional Portable Radiologic Services Inc.

  • Physiological Laboratory
  • Houston, TX
  • NPI 1457087991
  NPD (past)

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1336525609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST STE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081844",
            "telephone_number": "510-350-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MISSION BLVD",
            "address_2": "1ST FLOOR",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422564",
            "telephone_number": "209-223-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "AUSILIO",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mason Ross Womack
• Roland E Womack, DDS
• Stenson Womack, DMD
• Gary J Woodward, M.D.
• Brandon S Wright
• James Gregory Wright, P.T.
• Mason Alexander Wright
• Susan Wright, O.T.R./L

• Physician Assistant in Jackson, CA
• Providers in Jackson, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.