Individual provider Active NPI

Kimberly Angela Wong, M.D.

  • Gastroenterology Physician
  • Sacramento, CA
National Provider Identifier
1528486479
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A139747 Issued in CA
Practice address
4150 V St
#1100
Sacramento, CA 95817-1460
Phone
(916) 734-2737
NPI assigned
Mar 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A139747 CA Primary
General Practice Physician 208D00000X A139747 CA

Addresses

Primary practice location

4150 V St
#1100
Sacramento, CA 95817-1460

Mailing address

4150 V St
#1100
Sacramento, CA 95817-1460
Phone (916) 734-2737

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170615002534 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 3577854553 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Boston University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

10850 White Rock Rd
Rancho Cordova, CA 95670-6044

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

2440 W Covell Blvd
Davis, CA 95616-5671
Phone (530) 747-3000

3160 Folsom Blvd
Suite 3500
Sacramento, CA 95816-5270
Phone (916) 731-1820

4860 Y St
Sacramento, CA 95817-2307

4861 Y St
Sacramento, CA 95817-2307
Phone (916) 734-2525

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy112
Upper gastrointestinal (GI) endoscopy for acid reflux106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
139747CAMDMarriage & Family Therapist
A139747CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the University of California CurrentSince Jul 1, 2023 Accepting new patients
Regents of the University of California CurrentSince Jul 1, 2023 Accepting new patients
Regents of the Univ of Ca Gastroenterology CurrentSince Jul 1, 2023 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

2660 W Covell Blvd
Davis, CA 95616
Phone (530) 747-3000

2440 W Covell Blvd
Davis, CA 95616
Phone (530) 668-2646

8110 Laguna Blvd
Elk Grove, CA 95758
Phone (916) 683-3955

2400 Del Paso Rd
Ste 145
Sacramento, CA 95834
Phone (916) 928-3940

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

3160 Folsom Blvd
Ste 3500
Sacramento, CA 95816
Phone (916) 734-0779

Organizations & group practices 6

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 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": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1528486479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 V ST",
            "address_2": "#1100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-734-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 V ST",
            "address_2": "#1100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-734-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KIMBERLY",
        "middle_name": "ANGELA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-28",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A139747",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A139747",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.