Grace K. Wong, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10607T Issued in CA

Practice address

80 N Lake Ave
#102
Pasadena, CA 91101-5626

Phone

(626) 356-8088

Fax

(626) 356-8078

NPI assigned

Jan 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mike V Wong O D a Professional CorpGroup PAC ID 9931188554, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mike V Wong OD a Professional Corp

  • Optometrist
  • Pasadena, CA
  • NPI 1760403430
  Medicare reassignment Care Compare group
• Dr. Carolyn Wong

  • Optometrist
  • Los Angeles, CA
  • NPI 1710137708
  NPD (past)

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1467423301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6043 AGNES AVE",
            "city": "TEMPLE CITY",
            "state": "CA",
            "postal_code": "917801708",
            "telephone_number": "626-451-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 N LAKE AVE",
            "address_2": "#102",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911015626",
            "telephone_number": "626-356-8088",
            "fax_number": "626-356-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "GRACE",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10607T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0106070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher David Wong, DPT
• Connie Mabel Wong, OTR/L
• Erika Wong
• Esther Wong
• Ewen Wong, NP
• Grant Wong
• James Wah Wong, MD
• Jameson Wong
• Jamie Sue Wong, MA, BCBA
• Jeannie Wong, LAC, DAOM

• Optometrist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.