Individual provider Active NPI

Anthony Wong, MD

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Beverly Hills, CA
National Provider Identifier
1669036257
Registry record updated Oct 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
A200971 Issued in CA
Practice address
9675 Brighton Way Ste 410
Beverly Hills, CA 90210-5192
Phone
(310) 363-8757
NPI assigned
Apr 29, 2019
Last updated
Oct 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X A200971 CA Primary
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X 28255 NV

Addresses

Primary practice location

9675 Brighton Way Ste 410
Beverly Hills, CA 90210-5192

Mailing address

9675 Brighton Way Ste 410
Beverly Hills, CA 90210-5192

Other practice location 1

150 N Robertson Blvd Ste 314
Beverly Hills, CA 90211-2145
Phone (310) 657-4302

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250930002041 CA Practitioner - OphthalmologyPractitioner - Plastic and Reconstructive Surgery 0244634350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Plastic and Reconstructive Surgery
Education
Rush Medical College of Rush University, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3426 Black Willow Trail
Deland, FL 32724-7226

732 Innsbruck Dr
Orlando, FL 32825-6644

9675 Brighton Way
Suite 410
Beverly Hills, CA 90210-5192

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A200971CAMDOphthalmic Plastic and Reconstructive Surgery Physician
28255NVMDOphthalmic Plastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Health IV Clinic PC CurrentSince Aug 4, 2025 Accepting new patients
Thrive Health IV Clinic, P.C. Current Accepting new patients
Thrive Health IV Clinic PC CurrentSince Aug 4, 2025 Accepting new patients

Locations

9675 Brighton Way
Ste 410
Beverly Hills, CA 90210
Phone (310) 274-2525

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761436800000",
    "number": "1669036257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9675 BRIGHTON WAY STE 410",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9675 BRIGHTON WAY STE 410",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105192",
            "telephone_number": "310-363-8757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 N Robertson Blvd Ste 314",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902112145",
            "country_code": "US",
            "telephone_number": "310-657-4302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-29",
        "last_updated": "2025-10-26",
        "certification_date": "2025-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A200971",
            "primary": true
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "NV",
            "license": "28255",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.