Individual provider Active NPI

Dorothy Lai Ping Wong, MD

  • Internal Medicine Physician
  • Yuma, AZ
National Provider Identifier
1356315865
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD22877 Issued in AZ
Practice address
1025 W 24TH St
Suite 26
Yuma, AZ 85364-8366
Phone
(928) 344-5455
Fax
(928) 344-5465
NPI assigned
Feb 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD22877 AZ Primary

Addresses

Primary practice location

1025 W 24TH St
Suite 26
Yuma, AZ 85364-8366

Mailing address

1025 W 24TH St
Suite 26
Yuma, AZ 85364-8366
Phone (928) 344-5455

Other identifiers 5

IdentifierTypeStateIssuer
860917930OtherAZTID
MD22877OtherAZSTATE LICENCE
110180845OtherAZRR MEDICARE
330085MedicaidAZ
AZ0805637OtherAZBCBS AZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD22877AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalists of Yuma Past Accepting new patients

Organizations & group practices 1

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1356315865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 W 24TH ST",
            "address_2": "SUITE 26",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648366",
            "telephone_number": "928-344-5455",
            "fax_number": "928-344-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 W 24TH ST",
            "address_2": "SUITE 26",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648366",
            "telephone_number": "928-344-5455",
            "fax_number": "928-344-5465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "DOROTHY",
        "middle_name": "LAI PING",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "MD22877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TID",
            "identifier": "860917930",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "MD22877",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110180845",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330085",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AZ",
            "identifier": "AZ0805637",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.