Organization Active NPI

Rosie Mo Wong, OD, Optometric Corporation

  • Optometrist
  • Monrovia, CA
National Provider Identifier
1376276725
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ROSIE MO WONG, OD, OPTOMETRIC CORPORATION
Practice address
945 W Duarte Rd
Monrovia, CA 91016-4306
Phone
(626) 780-7093
NPI assigned
Jul 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Authorized official

Name
Dr. Rosie Mo Wong, ODNPI 1922383587
Title
Optometrist
Phone
(626) 501-3773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

945 W Duarte Rd
Monrovia, CA 91016-4306

Mailing address

945 W Duarte Rd
Monrovia, CA 91016-4306
Phone (626) 501-3773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230228001517 CA Part B Supplier - Clinic/Group Practice 7416320114 Receives reassigned benefits from 1 practitioner
Practice locations: Monrovia, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1376276725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 W DUARTE RD",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910164306",
            "telephone_number": "626-501-3773",
            "fax_number": "626-501-3915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 W DUARTE RD",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910164306",
            "telephone_number": "626-780-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSIE MO WONG, OD, OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-05",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "ROSIE",
        "authorized_official_middle_name": "MO",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "626-501-3773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monrovia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.