Active NPI
Cecil C. Wong, O.D.
- Optometrist
- Maple Shade, NJ
National Provider Identifier
1497816136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 27OA00484700
- Practice address
- 490 S Lenola Rd Ste B
Maple Shade, NJ 08052-1618 - Phone
- (856) 787-9875
- Fax
- (856) 787-9754
- NPI assigned
- Dec 13, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 27OA00484700 | NJ | Primary |
Addresses
Primary practice location
490 S Lenola Rd Ste B
Maple Shade, NJ 08052-1618
Mailing address
490 S Lenola Rd Ste B
Maple Shade, NJ 08052-1618
Phone (856) 787-9875
Medicare participation
Medicare enrollment files- 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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050803000068 | NJ | Practitioner - Optometry | 9931137684 | Practice locations: Maple Shade, NJ |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1987
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
490 B S Lenola Rd
Maple Shade, NJ 08052-1618
490 S Lenola Rd
Suite B
Maple Shade, NJ 08052-1618
490 S Lenola Rd B
Maple Shade, NJ 08052-1618
Phone (609) 787-9875
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| For Eyes Optical of PA | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497816136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "490 S LENOLA RD STE B",
"city": "MAPLE SHADE",
"state": "NJ",
"postal_code": "080521618",
"telephone_number": "856-787-9875",
"fax_number": "856-787-9754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "490 S LENOLA RD STE B",
"city": "MAPLE SHADE",
"state": "NJ",
"postal_code": "080521618",
"telephone_number": "856-787-9875",
"fax_number": "856-787-9754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "CECIL",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "27OA00484700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Maple Shade, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.