Individual provider Active NPI

Hanwen Wong, PT, DPT

  • Physical Therapist
  • Saint Paul, MN
National Provider Identifier
1609443266
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12262 Issued in MN
Practice address
2155 Ford Pkwy
Saint Paul, MN 55116-2799
Phone
(215) 555-1161
NPI assigned
Jun 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12262 MN Primary

Addresses

Primary practice location

2155 Ford Pkwy
Saint Paul, MN 55116-2799

Mailing address

654 Sunset CT
Shoreview, MN 55126-1235
Phone (763) 350-1678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210715004085 MN Practitioner - Physical Therapist in Private Practice 2264834043 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Mayo Medical School, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

2700 Vikings Cir
Eagan, MN 55121-1002
Phone (952) 456-7600

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12262MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Infinite Health Collaborative, PA CurrentSince Jul 1, 2023 Accepting new patients
Fairview Express Care CurrentSince Jun 26, 2021 Accepting new patients
Fairview Express Care CurrentSince Jun 26, 2021 Accepting new patients
Infinite Health Collaborative, PA Physical Therapist CurrentSince Jul 1, 2023 Accepting new patients

Locations

2700 Vikings Cir
Eagan, MN 55121
Phone (952) 456-7600

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

2155 Ford Pkwy
Saint Paul, MN 55116
Phone (651) 696-5000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1609443266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 SUNSET CT",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551261235",
            "telephone_number": "763-350-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551162799",
            "telephone_number": "215-555-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "HANWEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "12262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.