Individual provider Active NPI

Annie Ye Wong, PA

  • Physician Assistant
  • Duarte, CA
National Provider Identifier
1467105437
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA64342 Issued in CA
Practice address
1500 Duarte Rd
Duarte, CA 91010-3012
Phone
(800) 826-4673
NPI assigned
Jan 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA64342 CA Primary

Addresses

Primary practice location

1500 Duarte Rd
Duarte, CA 91010-3012

Mailing address

PO Box 512185
Los Angeles, CA 90051-0185

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@cityofhope.direct-ci.com Direct CITY OF HOPE MEDICAL FOUNDATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220418001833 MA Practitioner - Physician Assistant 1355738576
I20241008002491 CA Practitioner - Physician Assistant 1355738576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Tufts University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of Hope Medical FoundationGroup PAC ID 3779751656, 964 clinicians

Practice addresses (Care Compare)

1000 Fivepoint
Irvine, CA 92618-2377
Phone (949) 671-4673

1500 Duarte Rd
Duarte, CA 91010-3012
Phone (626) 256-4673

1500 E Duarte Rd
Duarte, CA 91010-3012

209 Fair Oaks Ave
South Pasadena, CA 91030-1814
Phone (626) 396-2900

Hospital & facility affiliations

  • City of Hope Helford Clinical Research Hospital Hospital, Duarte, CA, CCN 050146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
64342CAMDDentist
PA64342CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Medical Group, Inc CurrentSince Apr 18, 2022 Accepting new patients
Pratt Medical Group, Inc CurrentSince Apr 18, 2022 Accepting new patients
City of Hope Medical Foundation CurrentSince Sep 1, 2024 Accepting new patients

Locations

1500 Duarte Rd
Duarte, CA 91010
Phone (626) 359-8111

209 Fair Oaks Ave
South Pasadena, CA 91030
Phone (626) 359-8111

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

Interoperability endpoints

  • Direct secure messaging: awong211064@cityofhope.direct-ci.com
  • Direct secure messaging: direct@cityofhope.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.

Hospital & facility affiliations 1

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": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1467105437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512185",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DUARTE RD",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910103012",
            "telephone_number": "800-826-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "ANNIE",
        "middle_name": "YE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@cityofhope.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1500 Duarte Rd",
            "city": "Duarte",
            "state": "CA",
            "country_code": "US",
            "postal_code": "910103012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duarte, CA

Sources for this page

Verify at the official NPI Registry.