Keith Michael Wong, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

34715 Issued in CA

Practice address

18120 Brookhurst St
Ste 19
Fountain Valley, CA 92708-6727

Phone

(949) 208-9009

NPI assigned

Apr 25, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in MA, CA, TX, NY4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Optometry

Education

New England College of Optometry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Total Vision PCGroup PAC ID 9234472242, 115 clinicians

Med Southwest PLLCGroup PAC ID 4082952874, 234 clinicians

Troy Humphreys OD Faao, Professional CorporationGroup PAC ID 9335564970, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations (25 of 37)

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.

• Total Vision PC

  • Optometrist
  • San Diego, CA
  • NPI 1356813711
  Medicare reassignment Care Compare group NPD
• Troy Humphreys OD Faao, Professional Corporation

  • Optometrist
  • Susanville, CA
  • NPI 1326660960
  Medicare reassignment Care Compare group NPD
• Med Southwest, PLLC

  • Optometrist
  • Houston, TX
  • NPI 1609348739
  Medicare reassignment Care Compare group NPD
• Fifth Optometric Care of California

  • Optometrist
  • San Jose, CA
  • NPI 1215627914
  Medicare reassignment NPD
• Aeg Texas Professional PLLC

  • Optometrist
  • Kerrville, TX
  • NPI 1457905937
  Medicare reassignment NPD
• Brownwood Optometrists, P.C.

  • Optometrist
  • Early, TX
  • NPI 1063596849
  Medicare reassignment NPD
• Ejmvkk Associates Inc

  • Optometrist
  • Ozone Park, NY
  • NPI 1992189153
  Medicare reassignment NPD
• Empire Vision Center Inc

  • Optometrist
  • Syracuse, NY
  • NPI 1750358826
  Medicare reassignment NPD
• Foley Vision Center LLC

  • Optometrist
  • Amesbury, MA
  • NPI 1063908960
  Medicare reassignment NPD
• Framebar Co LLC

  • Optometrist
  • Oceanside, NY
  • NPI 1295384139
  Medicare reassignment NPD
• Myeyedr Optometry of Massachusetts P C

  • Optometrist
  • Amherst, MA
  • NPI 1124534946
  Medicare reassignment NPD
• SDR Practices, LLC

  • Optometrist
  • Ballinger, TX
  • NPI 1750585402
  Medicare reassignment NPD

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1568950657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18120 BROOKHURST ST",
            "address_2": "STE 19",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086727",
            "telephone_number": "714-508-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18120 BROOKHURST ST",
            "address_2": "STE 19",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086727",
            "telephone_number": "949-208-9009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "870 Providence Hwy",
            "address_purpose": "LOCATION",
            "city": "Dedham",
            "state": "MA",
            "postal_code": "02026",
            "country_code": "US",
            "telephone_number": "781-329-0067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "KEITH",
        "middle_name": "MICHAEL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-25",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100657",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34715",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11124T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5295",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "OPT-OPT-LIC-5171",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "011064",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Wong, DO
• Janice Anh Wong, PHAM.D.
• Jeffrey Wong, M.D.
• Jennifer L Wong, M.D.
• Jennifer Tomiko Wong, PTA
• Marilyn Wong
• Michael Henry Wong, D.O.
• Richard Man-Kim Wong, M.D.
• Lynette Woo-Sam, RN, FNP-BC
• Kerry E Wood, NP

• Optometrist in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.