Timothy L Wong, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

25MB10954800 Issued in NJ

Practice address

100 Century Pkwy Ste 350
Mount Laurel, NJ 08054-1149

Phone

(609) 941-5486

NPI assigned

Jun 29, 2018

Last updated

Mar 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Timothy Lok Kan Wong Other name

Electronic endpoints 1

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

Specialty

Psychiatry

Education

Lake Erie College of Osteopathic Medicine, Erie, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029
• Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515
  Medicare reassignment Care Compare group NPD
• Inspira Health Network Medical Group, P.C.

  dba Inspira Medical Group

  • Multi-Specialty Clinic/Center
  • Glassboro, NJ
  • NPI 1922177856
  Medicare reassignment NPD
• Virtua Medical Group, PA

  • Urgent Care Clinic/Center
  • Moorestown, NJ
  • NPI 1184174849
  NPD
• Virtua Medical Group, PA

  dba Virtua Reconstructive Orthopedics - Delran

  • Orthopaedic Surgery Physician
  • Delran, NJ
  • NPI 1841087988
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kennedy University Hospital Inc.

  • General Acute Care Hospital
  • Stratford, NJ
  • NPI 1386746592
  Care Compare affiliation
• Virtua Our Lady of Lourdes Hospital Inc

  dba Virtua Our Lady of Lourdes Hospital

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1235134024
  Care Compare affiliation

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1467947556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CENTURY PKWY STE 350",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541149",
            "telephone_number": "856-482-9000",
            "fax_number": "856-482-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CENTURY PKWY STE 350",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541149",
            "telephone_number": "609-941-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "TIMOTHY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-29",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MB10954800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twong176021@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Century Pkwy Ste 350",
            "city": "Mount Laurel",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080541149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TIMOTHY",
            "last_name": "WONG",
            "middle_name": "LOK KAN",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cassandra Wilson, MA, BCBA, LBS, LBA
• Joseph Wingo
• Rachel Wint, PA-C
• WK Interstate LLC (Amada Senior Care NJ-South)
• Mo Wong, PHARM. D.
• Melissa Anne Wood, MS, CCC-SLP
• Jamella Woodridge
• Workright PT, Inc.
• Wrapped N Love Homecare
• Akeia Wright, LSW

• Psychiatry Physician in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.