Individual provider Active NPI

Ching Yee Wong, MD

  • Nuclear Medicine Physician
  • Sacramento, CA
National Provider Identifier
1396705356
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Medicine PhysicianTaxonomy code 207U00000X
License
C144795 Issued in CA
Practice address
1500 Expo Pkwy
Sutter Health Imaging
Sacramento, CA 95815-4227
Phone
(248) 701-8979
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X 4301073055 MI
Nuclear Medicine Physician 207U00000X C144795 CA Primary

Addresses

Primary practice location

1500 Expo Pkwy
Sutter Health Imaging
Sacramento, CA 95815-4227

Mailing address

1500 Expo Pkwy
Sutter Health Imaging
Sacramento, CA 95815-4227
Phone (248) 701-8979

Other identifiers 2

IdentifierTypeStateIssuer
3521647MedicaidMI
010F362410OtherMIBCBSM

Other names 1

  • Ching-Yee Wong Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20170130001501 CA Practitioner - Nuclear MedicinePractitioner - Internal Medicine 4082742192 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nuclear MedicineAlso: Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians
Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 454-6868

2241 Douglas Blvd
Suite 110And100
Roseville, CA 95661-4260
Phone (916) 783-8900

2261 Douglas Blvd
Roseville, CA 95661-3831
Phone (916) 791-0900

2800 L St
Sacramento, CA 95816-5616

3161 L St
Sacramento, CA 95816-5234
Phone (916) 453-9999

4647 Zion Ave
San Diego, CA 92120-2507
Phone (619) 528-5000

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211

815 Court St
Jackson, CA 95642-2154

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C144795CAMDNuclear Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Feb 2, 2017 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 26, 2017 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 26, 2017 Accepting new patients
Sutter Valley Medical Foundation Nuclear Medicine CurrentSince Feb 2, 2017 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 26, 2017 Accepting new patients

Locations

1011 Baldwin Park Blvd
Baldwin Park, CA 91706
Phone (626) 851-1011

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

1500 Expo Pkwy
Sacramento, CA 95815
Phone (916) 646-8300

3161 L St
Sacramento, CA 95816
Phone (916) 453-9999

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

Interoperability endpoints

  • Direct secure messaging: cwong360382@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1396705356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 EXPO PKWY",
            "address_2": "SUTTER HEALTH IMAGING",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154227",
            "telephone_number": "248-701-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 EXPO PKWY",
            "address_2": "SUTTER HEALTH IMAGING",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154227",
            "telephone_number": "248-701-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "CHING",
        "middle_name": "YEE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "MI",
            "license": "4301073055",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "CA",
            "license": "C144795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3521647",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "010F362410",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHING-YEE",
            "last_name": "WONG",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.