Organization Active NPI

Raymond F Wong M D P C

  • Medical Specialty Clinic/Center
  • New York, NY
National Provider Identifier
1396895173
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
183388 Issued in NY
Legal business name
RAYMOND F WONG M D P C
Practice address
139 Centre St
Suite Ph105
New York, NY 10013-4552
Phone
(212) 227-5451
NPI assigned
Jan 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Authorized official

Name
Dr. Raymond F Wong, M.D.NPI 1619083425
Title
President
Phone
(212) 227-5451

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
Medical Specialty Clinic/Center 261QM2500X 183388 NY Primary

Addresses

Primary practice location

139 Centre St
Suite Ph105
New York, NY 10013-4552

Mailing address

139 Centre St
Suite Ph105
New York, NY 10013-4552
Phone (212) 227-5451

Other identifiers 2

IdentifierTypeStateIssuer
03291678MedicaidNY
58F22OtherNYEMPIRE BLUE CROSS SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080606000541 NY Part B Supplier - Clinic/Group Practice 8921178609 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

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": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1396895173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 CENTRE ST",
            "address_2": "SUITE PH105",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134552",
            "telephone_number": "212-227-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 CENTRE ST",
            "address_2": "SUITE PH105",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134552",
            "telephone_number": "212-227-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMOND F WONG M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-227-5451",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "183388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03291678",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS SHIELD",
            "identifier": "58F22",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.