Individual provider Active NPI

Jasmine Pearl Mae Wong, M.D.

  • Family Medicine Physician
  • Toledo, OH
National Provider Identifier
1508210626
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35138731 Issued in OH
Practice address
3425 Executive Pkwy Ste 100
Toledo, OH 43606-1326
Phone
(419) 472-1124
Fax
(419) 486-8857
NPI assigned
Apr 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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 35138731 OH Primary

Addresses

Primary practice location

3425 Executive Pkwy Ste 100
Toledo, OH 43606-1326

Mailing address

3425 Executive Pkwy Ste 100
Toledo, OH 43606-1326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20230720001153 OH Practitioner - Family Practice 2466747233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians-North LLCGroup PAC ID 2668522400, 131 clinicians

Practice addresses (Care Compare)

2222 Cherry St
Toledo, OH 43608-2675

3425 Executive Pkwy
Suite 100
Toledo, OH 43606-1326
Phone (419) 472-1124

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35138731OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians-North LLC Family Medicine CurrentSince Jul 2, 2023 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Jul 2, 2023 Accepting new patients
Mercy Health System Northern Past Accepting new patients

Locations

3425 Executive Pkwy
Ste 100
Toledo, OH 43606
Phone (419) 472-1124

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1508210626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 EXECUTIVE PKWY STE 100",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 EXECUTIVE PKWY STE 100",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061326",
            "telephone_number": "419-472-1124",
            "fax_number": "419-486-8857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "JASMINE",
        "middle_name": "PEARL MAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-14",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35138731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.