Individual provider Active NPI

Winnie Wong

  • Family Medicine Physician
  • Cambridge, MA
National Provider Identifier
1639603202
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
286773 Issued in MA
Practice address
1493 Cambridge St
Cambridge, MA 02139-1047
Phone
(781) 338-0500
NPI assigned
Apr 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 286773 MA Primary

Addresses

Primary practice location

1493 Cambridge St
Cambridge, MA 02139-1047

Mailing address

454 Broadway FL 3
Revere, MA 02151-3034
Phone (781) 338-0500

Other practice location 1

454 Broadway Fl 3
Revere, MA 02151
Phone (781) 485-8250

Other practice location 2

391 Broadway
Everett, MA 02149
Phone (617) 394-7702

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20211006001278 MA Practitioner - Family Practice 8325446370 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Boston University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harbor Medical Associates IncGroup PAC ID 2466356209, 130 clinicians

Practice addresses (Care Compare)

1493 Cambridge St
Cambridge, MA 02139-1047
Phone (617) 665-1000

15 Corporate Park Dr
Pembroke, MA 02359-1966
Phone (781) 826-8065

541 Main St
Suite 101
S Weymouth, MA 02190-1845
Phone (781) 331-7799

541 Main St
Suite 314
South Weymouth, MA 02190-1857
Phone (781) 952-1460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
286773MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission CurrentSince Sep 27, 2021 Accepting new patients
Harbor Medical Associates, Inc. Family Medicine CurrentSince Jan 1, 2024 Accepting new patients
Harbor Medical Associates, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Jan 1, 2026 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Cambridge Public Health Commission Past Accepting new patients

Locations

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

163 Gore St
East Cambridge, MA 02141
Phone (617) 499-6690

391 Broadway
Everett, MA 02149
Phone (617) 387-0473

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

454 Broadway
Revere, MA 02151
Phone (617) 389-4666

454 Broadway
Fl 3
Revere, MA 02151
Phone (781) 485-8222

541 Main St
Ste 314
Weymouth, MA 02190
Phone (781) 952-1200

Interoperability endpoints

  • Direct secure messaging: wong.winnie.bwh@direct.partners.masshiway.net

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1639603202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 BROADWAY FL 3",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021513034",
            "telephone_number": "781-338-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391047",
            "telephone_number": "781-338-0500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "454 Broadway Fl 3",
            "address_purpose": "LOCATION",
            "city": "Revere",
            "state": "MA",
            "postal_code": "02151",
            "country_code": "US",
            "telephone_number": "781-485-8250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "391 Broadway",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "MA",
            "postal_code": "02149",
            "country_code": "US",
            "telephone_number": "617-394-7702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "WINNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "286773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.