Eileen Jan Wong, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2084P0800X Issued in MA

Practice address

180 Morton St
4North
Jamaica Plain, MA 02130-3735

Phone

(617) 626-9367

Fax

(617) 626-9578

NPI assigned

Sep 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Albert Einstein College of Medicine of Yeshiva University, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Oasis Behavioral Health Center LLCGroup PAC ID 8426485251, 3 clinicians

The Commonwealth of MassachusettsGroup PAC ID 8820906860, 141 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lemuel Shattuck Hospital Long-term care hospital, Jamaica Plain, MA, CCN 222006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Oasis Behavioral Health Center LLC

  • Psychiatry Physician
  • Norwood, MA
  • NPI 1639436918
  Medicare reassignment Care Compare group NPD
• The Commonwealth of Massachusetts

  • Long Term Care Hospital
  • Tewksbury, MA
  • NPI 1871680496
  Medicare reassignment Care Compare group NPD
• Bournewood Clinical Associates

  • Nurse Practitioner
  • Brookline, MA
  • NPI 1891780144

  Psychiatry

  NPD (past)
• First Psychiatric Planners, Inc

  • Psychiatric Hospital
  • Brookline, MA
  • NPI 1093714412
  NPD (past)
• The Commonwealth of Massachusetts

  • Long Term Care Hospital
  • Jamaica Plain, MA
  • NPI 1568532273
  NPD (past)

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

• The Commonwealth of Massachusetts

  • Long Term Care Hospital
  • Jamaica Plain, MA
  • NPI 1568532273

  Long-term care hospital

  Care Compare affiliation

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1528159332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 MORTON ST",
            "address_2": "4NORTH",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303735",
            "telephone_number": "617-626-9367",
            "fax_number": "617-626-9578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 MORTON ST",
            "address_2": "4NORTH",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303735",
            "telephone_number": "617-626-9367",
            "fax_number": "617-626-9578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "EILEEN",
        "middle_name": "JAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "2084P0800X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Addis Woldeguiorguis
• Ahadu Woldemariam, PHARMD
• June Grant Wolf, PHD
• Susan Wolfe
• Jamie E Wolff, M.A.
• Myung Soon Woo-Roderick, NURSE PRACTITIONER
• Bryan Richard Wood, PHARMD
• Susan P Wood, NP
• Cheyanne Joy Woodrow
• Randi B. Woodrow, PT

• Psychiatry Physician in Jamaica Plain, MA
• Providers in Jamaica Plain, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.