Individual provider Active NPI

David Wong, PT, DPT, CSCS

  • Physical Therapist
  • Elk Grove, CA
National Provider Identifier
1649783192
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
293970 Issued in CA
Practice address
9280 W Stockton Blvd Ste 116
Elk Grove, CA 95758-8073
Phone
(916) 683-2580
NPI assigned
Nov 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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 293970 CA Primary

Addresses

Primary practice location

9280 W Stockton Blvd Ste 116
Elk Grove, CA 95758-8073

Mailing address

9280 W Stockton Blvd Ste 116
Elk Grove, CA 95758-8073
Phone (916) 683-2580

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190425001495 CA Practitioner - Physical Therapist in Private Practice 5799027645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

9280 W Stockton Blvd
Suite 116
Elk Grove, CA 95758-8073
Phone (916) 683-2580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
293970CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Physical Therapist CurrentSince Apr 8, 2019 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Jun 29, 2021 Accepting new patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Apr 8, 2019 Accepting new patients

Locations

9280 W Stockton Blvd
Ste 116
Elk Grove, CA 95758
Phone (916) 683-2580

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

10470 Old Placerville Rd
Ste 100
Sacramento, CA 95827

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

420 B St
Yuba City, CA 95991
Phone (530) 674-8850

Organizations & group practices 4

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": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1649783192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9280 W STOCKTON BLVD STE 116",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957588073",
            "telephone_number": "916-683-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9280 W STOCKTON BLVD STE 116",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957588073",
            "telephone_number": "916-683-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "DAVID",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-07",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "293970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.