Individual provider Active NPI

Timothy Wong, M.D.

  • Family Medicine Physician
  • Wilmington, DE
National Provider Identifier
1417913864
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
00005266 Issued in DE
Practice address
1851 Marsh Rd
Plaza III
Wilmington, DE 19810-4505
Phone
(302) 475-2700
Fax
(302) 529-7970
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 00005266 DE Primary

Addresses

Primary practice location

1851 Marsh Rd
Plaza III
Wilmington, DE 19810-4505

Mailing address

1851 Marsh Rd
Plaza III
Wilmington, DE 19810-4505
Phone (302) 475-2700

Other identifiers 1

IdentifierTypeStateIssuer
0000875501MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00005266DEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Total Care, Inc. Family Medicine Past Accepting new patients
Ah Nursing and Office Administration, Inc. Family Medicine Past Accepting new patients
Family Care Associates, Inc Family Medicine Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417913864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 MARSH RD",
            "address_2": "PLAZA III",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104505",
            "telephone_number": "302-475-2700",
            "fax_number": "302-529-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 MARSH RD",
            "address_2": "PLAZA III",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104505",
            "telephone_number": "302-475-2700",
            "fax_number": "302-529-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "00005266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000875501",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.