Individual provider Active NPI

Tina Wong, M.D.

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1497847578
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
239179 Issued in NY
Practice address
762 59TH St
Brooklyn, NY 11220-3936
Phone
(718) 567-8899
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 239179 NY Primary

Addresses

Primary practice location

762 59TH St
Brooklyn, NY 11220-3936

Mailing address

762 59TH St
Brooklyn, NY 11220-3936
Phone (718) 567-8899

Other identifiers 1

IdentifierTypeStateIssuer
02838402MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20071219000063 NY Practitioner - Family Practice 4688764384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York Downstate Medical Center, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chinatown True Care Medical PLLCGroup PAC ID 2163859760, 245 clinicians

Practice addresses (Care Compare)

128 Mott St
Suite 309
New York, NY 10013-5575
Phone (718) 439-3250

8686 Bay Pkwy
Suite M1
Brooklyn, NY 11214-5193
Phone (718) 372-0888

Merit-based Incentive Payment System (MIPS)

Final score
55 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
40
Cost
100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
239179NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chinatown True Care Medical PLLC Family Medicine CurrentSince Nov 23, 2022 Accepting new patients

Locations

762 59th St
Brooklyn, NY 11220
Phone (718) 393-5333

757 60th St
Ste 1
Brooklyn, NY 11220
Phone (718) 567-8899

4235 Main St
Ste 3E
Flushing, NY 11355
Phone (718) 886-5068

3907 Prince St
Ste 4F
Flushing, NY 11354
Phone (718) 939-3780

128 Mott St
Ste 308
New York, NY 10013
Phone (212) 966-9889

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1497847578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 59TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203936",
            "telephone_number": "718-567-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 59TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203936",
            "telephone_number": "718-567-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "TINA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "239179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02838402",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.