Individual provider Active NPI

Hector Jacob Leon-Wong, M.D.

  • Family Medicine Physician
  • Union City, NJ
National Provider Identifier
1457573321
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MA059074 Issued in NJ
Practice address
410 22ND St
Union City, NJ 07087-4414
Phone
(201) 223-4224
NPI assigned
May 2, 2007
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 MA059074 NJ Primary

Addresses

Primary practice location

410 22ND St
Union City, NJ 07087-4414

Mailing address

991 Aldus St # 2
Bronx, NY 10459-3706
Phone (718) 991-6581

Other identifiers 1

IdentifierTypeStateIssuer
6750508MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20091222000478 NJ Practitioner - Family Practice 2961542980 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA059074NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Pri-Med Care PA Family Medicine CurrentSince Dec 14, 2011 Accepting new patients
Cardio-Med Services LLC Past Accepting new patients
G&S Medical Associates LLC PastSince Dec 14, 2011 Accepting new patients

Locations

293 Monroe St
Passaic, NJ 07055
Phone (973) 773-5568

Interoperability endpoints

  • Direct secure messaging: hector.leon-wong@optimummed.ehi.direct-ci.com

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457573321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 ALDUS ST # 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104593706",
            "telephone_number": "718-991-6581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 22ND ST",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070874414",
            "telephone_number": "201-223-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON-WONG",
        "first_name": "HECTOR",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA059074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6750508",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, NJ

Sources for this page

Verify at the official NPI Registry.