Individual provider Active NPI

Hannah Zetlin Wong, NP

  • Pediatric Nurse Practitioner
  • Valhalla, NY
National Provider Identifier
1629570155
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
382683 Issued in NY
Practice address
503 Grasslands Rd
Valhalla, NY 10595-1503
Phone
(914) 304-5250
NPI assigned
Feb 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 382683 NY Primary

Addresses

Primary practice location

503 Grasslands Rd
Valhalla, NY 10595-1503

Mailing address

24 Viceroy PL
Port Jefferson Station, NY 11776-2930
Phone (917) 499-8065

Other practice location 1

30 Ramland Rd S Ste 200A
Orangeburg, NY 10962-2626
Phone (845) 359-0010

Other names 1

  • Hannah Wong Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230427001403 NY Practitioner - Nurse Practitioner 8729443684 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice PC CurrentSince Jan 31, 2023 Accepting new patients
Boston Children's Health Physicians, LLP Past Accepting new patients

Locations

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629570155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 VICEROY PL",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762930",
            "telephone_number": "917-499-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 GRASSLANDS RD",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951503",
            "telephone_number": "914-304-5250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Ramland Rd S Ste 200A",
            "address_purpose": "LOCATION",
            "city": "Orangeburg",
            "state": "NY",
            "postal_code": "109622626",
            "country_code": "US",
            "telephone_number": "845-359-0010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZETLIN WONG",
        "first_name": "HANNAH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "WONG",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.