Active NPI
Alan Wong, MD
- Student in an Organized Health Care Education/Training Program
- Charlottesville, VA
National Provider Identifier
1457970386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1215 Lee St
Charlottesville, VA 22908-4668 - Phone
- (434) 243-1000
- Fax
- (434) 244-7551
- NPI assigned
- Apr 10, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1215 Lee St
Charlottesville, VA 22908-4668
Mailing address
1215 Lee St
Mailbox 800158
Charlottesville, VA 22908-0816
Phone (434) 243-1000
Other practice location 1
4725 N Federal Hwy
Fort Lauderdale, FL 33308-4668
Phone (954) 771-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200804002865 | FL | Order and Referring Only - Internal Medicine | 2365867603 | |
| I20230822003138 | VA | Order and Referring Only - Peripheral Vascular Disease | 2365867603 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1457970386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 LEE ST",
"address_2": "MAILBOX 800158",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229080816",
"telephone_number": "434-243-1000",
"fax_number": "434-244-7551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 LEE ST",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229084668",
"telephone_number": "434-243-1000",
"fax_number": "434-244-7551"
}
],
"practiceLocations": [
{
"address_1": "4725 N Federal Hwy",
"address_purpose": "LOCATION",
"city": "Fort Lauderdale",
"state": "FL",
"postal_code": "333084668",
"country_code": "US",
"telephone_number": "954-771-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WONG",
"first_name": "ALAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-04-10",
"last_updated": "2023-06-28",
"certification_date": "2023-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.