Individual provider Active NPI

Christine Kelly Wong, PA-C

  • Physician Assistant
  • Encinitas, CA
National Provider Identifier
1609432665
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
345 Saxony Rd Ste 105
Encinitas, CA 92024-2787
Phone
(760) 753-7374
NPI assigned
May 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

345 Saxony Rd Ste 105
Encinitas, CA 92024-2787

Mailing address

PO Box 42374
Phoenix, AZ 85080-2374
Phone (518) 681-7532

Other practice location 1

56 Milton Ave
Ballston Spa, NY 12020-1446
Phone (518) 681-7532

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
I20200120000037 CA Practitioner - Physician Assistant 7315372422 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1609432665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42374",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850802374",
            "telephone_number": "518-681-7532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SAXONY RD STE 105",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242787",
            "telephone_number": "760-753-7374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "56 Milton Ave",
            "address_purpose": "LOCATION",
            "city": "Ballston Spa",
            "state": "NY",
            "postal_code": "120201446",
            "country_code": "US",
            "telephone_number": "518-681-7532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "CHRISTINE",
        "middle_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.