Individual provider Active NPI

Shirley Patricia Wong, DO

  • Obstetrics & Gynecology Physician
  • Colton, CA
National Provider Identifier
1346313459
Registry record updated Mar 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20A8691 Issued in CA
Practice address
400 N Pepper Ave
Dept Women'S Health, 2ND Floor, Mob
Colton, CA 92324-1801
Phone
(909) 580-3470
Fax
(909) 580-6369
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2014

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 20A8691 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
Dept Women'S Health, 2ND Floor, Mob
Colton, CA 92324-1801

Mailing address

400 N Pepper Ave
Dept Women'S Health, 2ND Floor, Mob
Colton, CA 92324-1801
Phone (909) 580-3470

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
I20051208000696 CA Practitioner - Obstetrics/Gynecology 4688695448 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Obstetrics and Gynecology Medical Group IncGroup PAC ID 7113911470, 10 clinicians

Practice addresses (Care Compare)

400 N Pepper Ave
2Mob206
Colton, CA 92324-1801
Phone (909) 580-2270

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8691CAMDAcupuncturist
20A8691CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mommy and Me Medical Group, Inc. Obstetrics & Gynecology CurrentSince Sep 3, 2017 Accepting new patients
Valley Obstetrics & Gynecology Medical Group, Inc. Obstetrics & Gynecology CurrentSince Oct 3, 2016 Accepting new patients
Senior'S Choice Medical Group, Inc. PastSince Mar 25, 2018 Accepting new patients
Reuben C Castillo, Professional Corporation Past Accepting new patients

Locations

400 N Pepper Ave
Fl 2
Colton, CA 92324
Phone (909) 580-2440

400 N Pepper Ave
#2
Colton, CA 92324
Phone (909) 580-2270

498 W 4th St
Perris, CA 92570
Phone (951) 657-5441

4190 Chicago Ave
Riverside, CA 92507
Phone (951) 632-2106

595 N Arrowhead Ave
Sn Bernrdno, CA 92401

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: shirley.wong.p2@direct.mpmccorp.nextgenshare.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 1

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1346313459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "DEPT WOMEN'S HEALTH, 2ND FLOOR, MOB",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-3470",
            "fax_number": "909-580-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "DEPT WOMEN'S HEALTH, 2ND FLOOR, MOB",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-3470",
            "fax_number": "909-580-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "SHIRLEY",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A8691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.