Deen L Wong, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

MD4676 Issued in HI

Practice address

79-1019 Haukapila St
Kealakekua, HI 96750-7920

Phone

(808) 322-9366

Fax

(808) 324-1892

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pan Pacific Pathologists, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Ewa Beach, HI
  • NPI 1962479360
  Medicare reassignment NPD
• Clinical Laboratories of Hawaii LLP

  • Clinical Medical Laboratory
  • Ewa Beach, HI
  • NPI 1134195357
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1376621334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 652",
            "city": "KEALAKEKUA",
            "state": "HI",
            "postal_code": "967500652",
            "telephone_number": "808-322-9366",
            "fax_number": "808-324-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79-1019 HAUKAPILA ST",
            "city": "KEALAKEKUA",
            "state": "HI",
            "postal_code": "967507920",
            "telephone_number": "808-322-9366",
            "fax_number": "808-324-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "DEEN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "HI",
            "license": "MD4676",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "HI",
            "license": "MD4676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUEENS",
            "identifier": "MD4676",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407901",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMAA",
            "identifier": "990280549",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "A14983",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Logan Wiegand, PHARM.D.
• Gretchen S. Wigton, LCSW
• William C. H. Rhee, MD Inc
• Amanda Wilson, MA, CCC-SLP
• Lynn Wind
• Nathan Wong, PT, DPT
• Jody K Wozniak, D.O.
• Wynette Y Kitajima M.D Inc
• Carli Yamamoto, ATC
• Yaser Alsaadi

• Anatomic Pathology & Clinical Pathology Physician in Kealakekua, HI
• Providers in Kealakekua, HI by specialty
• Anatomic Pathology & Clinical Pathology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.