Individual provider Active NPI

Adrianne Wong

  • Physician Assistant
  • Torrance, CA
National Provider Identifier
1477196079
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA58243 Issued in CA
Practice address
5215 Torrance Blvd Ste 300
Torrance, CA 90503-4009
Phone
(424) 212-5361
Fax
(310) 316-3466
NPI assigned
Oct 26, 2019
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA58243 CA Primary

Addresses

Primary practice location

5215 Torrance Blvd Ste 300
Torrance, CA 90503-4009

Mailing address

1 Hope Dr
Tustin, CA 92782-0221
Phone (714) 247-0300

Other practice location 1

1100B N Tustin Ave # A
Santa Ana, CA 92705-3505
Phone (714) 247-0300

Other practice location 2

947 S Anaheim Blvd Ste 260
Anaheim, CA 92805-5591
Phone (714) 247-0300

Other practice location 3

1 Hope Dr
Tustin, CA 92782-0221
Phone (714) 247-0300

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201217001076 CA Practitioner - Physician Assistant 0648682872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2336 Santa Monica Blvd
Suite 204
Santa Monica, CA 90404-2938
Phone (310) 829-6789

4101 Torrance Blvd
Torrance, CA 90503-4607
Phone (310) 540-7676

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
96.07
Promoting interoperability
100
Improvement activities
40
Cost
71.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA58243CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation Multi-Specialty CurrentSince Nov 10, 2023 Accepting new patients
Hurtt Family Health Clinic Inc. Multi-Specialty CurrentSince Sep 16, 2020 Accepting new patients
Saint John's Health Clinic Multi-Specialty Past Accepting new patients

Locations

947 S Anaheim Blvd
Ste 260
Anaheim, CA 92805

1100 N Tustin Ave
Ste A
Santa Ana, CA 92705
Phone (714) 835-6055

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

5215 Torrance Blvd
Ste 300
Torrance, CA 90503
Phone (310) 303-6126

1 Hope Dr
Tustin, CA 92782
Phone (714) 247-4398

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: awong3074313@oc.providencedirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1572048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1477196079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOPE DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927820221",
            "telephone_number": "714-247-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 TORRANCE BLVD STE 300",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034009",
            "telephone_number": "424-212-5361",
            "fax_number": "310-316-3466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100B N Tustin Ave # A",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927053505",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "947 S Anaheim Blvd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928055591",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Hope Dr",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927820221",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "ADRIANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-26",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA58243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.