Jeffrey G Wong, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD455716 Issued in PA

Practice address

303 Benner Pike Ste 1
State College, PA 16801-7304

Phone

(814) 272-5660

Fax

(814) 272-5675

NPI assigned

Aug 29, 2006

Last updated

Nov 9, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Milton S Hershey Medical Center Physicians Group

  • Orthopaedic Surgery Physician
  • Hershey, PA
  • NPI 1710951744
  Medicare reassignment NPD
• The Milton S Hershey Medical Center Physician Group

  • Body Imaging Physician
  • Hershey, PA
  • NPI 1346215928
  NPD
• The Milton S Hershey Medical Center Physicians Group

  • Internal Medicine Physician
  • Hershey, PA
  • NPI 1609841337
  NPD
• Franklin Medical Group, PC

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Waterbury, CT
  • NPI 1780686964
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1558479402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "MC A410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 BENNER PIKE STE 1",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017304",
            "telephone_number": "814-272-5660",
            "fax_number": "814-272-5675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Ashley Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294250001",
            "country_code": "US",
            "telephone_number": "843-792-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "JEFFREY",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "AL27458",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD455716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q32070",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030496070001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judith A Withrow, PH.D.
• Paige Witkowski, DO
• David W. Wolfe, M.D.
• Kaitlee A Wolfe, CRNP
• Nicole Jean Wolfe, PA-C
• Molly Elizabeth Wood
• Gregory Lee Wright, L.AC.
• WSSH Powerback Rehabilitation Services, LLC
• Ian M Yarger, DPM
• Richard A Yarger II

• Internal Medicine Physician in State College, PA
• Providers in State College, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.