Gregory Kelii Wong, M.D.

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

A124939 Issued in CA

Practice address

1201 W la Veta Ave
Orange, CA 92868-4203

Phone

(714) 509-4099

Fax

(714) 509-3301

NPI assigned

Sep 9, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

GastroenterologyAlso: Pediatric Medicine

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Childrens Hospital of Orange CountyGroup PAC ID 6406944883, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Children's Hospital of Orange County

  dba CHOC Children's Specialists

  • Pediatrics Physician
  • Orange, CA
  • NPI 1275975104

  Pediatric Gastroenterology

  Medicare reassignment Care Compare group NPD
• Rady Children's Hospital San Diego

  dba Rady Children's Specialists of San Diego, A Medical Foundation

  • Pediatrics Physician
  • San Diego, CA
  • NPI 1669617197
  Medicare reassignment NPD
• Rady Children's Hospital San Diego

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Diego, CA
  • NPI 1851303994
  NPD
• Children's Hospital at Mission

  dba Rady Children's Hospital

  • Children's Hospital
  • Mission Viejo, CA
  • NPI 1699868398
  NPD (past)
• Children's Hospital of Orange County

  dba Rady Children's Hospital Orange County

  • Children's Hospital
  • Orange, CA
  • NPI 1811080526
  NPD (past)
• Marilyn Kaufhold, M.D., a Medical Corporation

  • Children's Hospital
  • San Diego, CA
  • NPI 1336359389
  NPD (past)

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1386977288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "714-509-4099",
            "fax_number": "714-509-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684203",
            "telephone_number": "714-509-4099",
            "fax_number": "714-509-3301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234232",
            "country_code": "US",
            "telephone_number": "858-966-4003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "GREGORY",
        "middle_name": "KELII",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-09",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "N7765",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "CA",
            "license": "A124939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon John Wong
• Brian Wong, MD
• Christina Wong
• Daphne L Wong, MD
• Ethan Ryan Wong
• Jason Chun Hang Wong, MD
• Jason Patrick Wong
• Jeffrey A Wong, MD
• Jennifer Lynn Wong, M.D.
• Joanne Wong, PHARMD

• Pediatric Gastroenterology Physician in Orange, CA
• Providers in Orange, CA by specialty
• Pediatric Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.