Individual provider Active NPI

Kai Y Wong, M.D.

  • Family Medicine Physician
  • Arcadia, CA
National Provider Identifier
1376656967
Registry record updated Jan 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A53447 Issued in CA
Practice address
624 W Duarte Rd
Ste 104
Arcadia, CA 91007-9253
Phone
(626) 898-4801
Fax
(626) 898-4802
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A53447 CA Primary

Addresses

Primary practice location

624 W Duarte Rd
Ste 104
Arcadia, CA 91007-9253

Mailing address

624 W Duarte Rd
Ste 104
Arcadia, CA 91007-9253
Phone (626) 898-4801

Other identifiers 1

IdentifierTypeStateIssuer
00A534471MedicaidCA

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
I20070201000208 CA Practitioner - General Practice 3274535422 Practice locations: Arcadia, CA; Monterey Park, CA

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

624 W Duarte Rd
Suite 104
Arcadia, CA 91007-9253
Phone (626) 898-4801

Hospital & facility affiliations

  • Allegiance Home Health, Inc Home health agency, Alhambra, CA, CCN 058253

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A53447CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ahmc Garfield Medical Center LP Past Accepting new patients
Alhambra Hospital Medical Center, LP Past Accepting new patients
Chua Chuang Inc. a Medical Past Accepting new patients
Kelly Wong DO Inc PastSince Jul 1, 2010 Accepting new patients
Dr. Tin S Wong DO Medical Corporation PastSince Oct 17, 2016 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609545600000",
    "number": "1376656967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 W DUARTE RD",
            "address_2": "STE 104",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910079253",
            "telephone_number": "626-898-4801",
            "fax_number": "626-898-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 W DUARTE RD",
            "address_2": "STE 104",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910079253",
            "telephone_number": "626-898-4801",
            "fax_number": "626-898-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KAI",
        "middle_name": "Y",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2021-01-02",
        "certification_date": "2021-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A53447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A534471",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.