Individual provider Active NPI

Audra Wong

  • Family Nurse Practitioner
  • Newport Beach, CA
National Provider Identifier
1528694957
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95013262 Issued in CA
Practice address
510 Superior Ave
Newport Beach, CA 92663-3663
Phone
(800) 400-4624
NPI assigned
Mar 17, 2020
Last updated
Sep 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95013262 CA Primary

Addresses

Primary practice location

510 Superior Ave
Newport Beach, CA 92663-3663

Mailing address

510 Superior Ave
Newport Beach, CA 92663-3663

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210726001544 CA Practitioner - Nurse Practitioner 9234532490 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
84.12
Promoting interoperability
100
Improvement activities
40
Cost
74.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health CurrentSince Apr 13, 2021 Accepting new patients
St. Johns Community Health Current Accepting new patients
St. Johns Community Health CurrentSince Apr 13, 2021 Accepting new patients
Hoag Clinic CurrentSince May 2, 2022 Accepting new patients
Hoag Hospital Past Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

2512 Alta St
Los Angeles, CA 90031
Phone (323) 441-2139

510 Superior Ave
Newport Beach, CA 92663
Phone (800) 400-4624

510 Superior Ave
Ste 200F
Newport Beach, CA 92663
Phone (949) 644-2722

1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1528694957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 SUPERIOR AVE",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 SUPERIOR AVE",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633663",
            "telephone_number": "800-400-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "AUDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-17",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.