NPIMap

Individual provider Active NPI

Andrew M Wong, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Tallahassee, FL
National Provider Identifier
1407859226
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
ME59819 Issued in FL
Practice address
3334 Capital Medical Blvd Ste 400
Tallahassee, FL 32308-4470
Phone
(850) 877-8174
Fax
(850) 877-5636
NPI assigned
May 24, 2005
Last updated
Nov 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X ME59819 FL
Orthopaedic Surgery Physician 207X00000X 050854 GA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X ME59819 FL Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 050854 GA

Addresses

Primary practice location

3334 Capital Medical Blvd Ste 400
Tallahassee, FL 32308-4470

Mailing address

3334 Capital Medical Blvd Ste 400
Tallahassee, FL 32308-4470
Phone (850) 877-8174

Other identifiers 3

IdentifierTypeStateIssuer
000932302BMedicaidGA
000932302AMedicaidGA
378584000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040827000704 GA Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 4789659301 Reassigns benefits to 1 organization
I20070317000031 FL Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 4789659301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Tulane University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

113 W Hansell St
Thomasville, GA 31792-6664
Phone (229) 226-3060

2011 Harrison Ave
Panama City, FL 32405-4545
Phone (850) 691-4188

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.5 of 100Reported as group
Quality
47.27
Promoting interoperability
99
Improvement activities
40
Cost
75.24

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement19
Knee replacement64
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME59819FLMDSports Medicine (Orthopaedic Surgery) Physician
050854GAMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Orthopedic Clinic III PL Orthopaedic Surgery CurrentSince Aug 6, 2001 Accepting new patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Aug 6, 2001 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
TMH Emergency Physician Group PastSince Oct 1, 2013 Accepting new patients
Tallahassee Orthopaedic Surgery Partners LTD PastSince Aug 1, 2022 Accepting new patients

Locations

2011 Harrison Ave
Panama City, FL 32405
Phone (850) 691-4188

1002 N Arnold Rd
Panama City Beach, FL 32413

2605 Welaunee Blvd
Tallahassee, FL 32308

3334 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 219-1932

3334 Capital Medical Blvd
Ste 400
Tallahassee, FL 32308

603 Wheat Ave
Bainbridge, GA 39819
Phone (229) 246-1209

603 Wheat Ave
Ste 800
Bainbridge, GA 39819
Phone (229) 246-3608

113 W Hansell St
Thomasville, GA 31792
Phone (229) 226-3060

Interoperability endpoints

  • Direct secure messaging: andrew.wong.1@18802.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tallahassee Memorial Healthcare IncTallahassee, FL, CCN 100135 Hospital Corporate Director Oct 1, 2013
Tallahassee Memorial Behavior Health CenterTallahassee, FL, CCN 10S135 Hospital Corporate Director Oct 1, 2013
Tallahassee Memorial Hospital Extended CareTallahassee, FL, CCN 105158 Skilled nursing facility Corporate Director Oct 1, 2013
Tallahassee Memorial Home Health CareTallahassee, FL, CCN 107115 Home health agency Corporate Director Oct 1, 2013
TMH Physician Partners, BlountstownBlountstown, FL, CCN 103997 Rural health clinic Corporate Director Oct 1, 2013
TMH Physician Partners, QuincyQuincy, FL, CCN 103429 Rural health clinic Corporate Director Oct 1, 2013
TMH Physician Parnters, WakullaCrawfordville, FL, CCN 103428 Rural health clinic Corporate Director Oct 1, 2013
Tallahassee Memorial Family Medicine MonticelloMonticello, FL, CCN 103409 Rural health clinic Corporate Director Oct 1, 2013

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1407859226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 CAPITAL MEDICAL BLVD STE 400",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084470",
            "telephone_number": "850-877-8174",
            "fax_number": "850-877-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 CAPITAL MEDICAL BLVD STE 400",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084470",
            "telephone_number": "850-877-8174",
            "fax_number": "850-877-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "ANDREW",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME59819",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "050854",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME59819",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "GA",
            "license": "050854",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000932302B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000932302A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378584000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.