Walter A Wong, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

10182T Issued in CA

Practice address

1880 S. Norfolk St.
San Mateo, CA 94403

Phone

(650) 830-5675

Fax

(650) 830-5675

NPI assigned

Feb 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of California - School of Optometry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anifa Avakian Stadtman, O.D.

  • Optometrist
  • Chandler, AZ
  • NPI 1396154456

  CA

  Medicare reassignment

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.

• Regents of the University of California at Berkeley

  • Optometrist
  • Berkeley, CA
  • NPI 1306908058
  Medicare reassignment NPD

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1689647414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 S. NORFOLK ST.",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "94403",
            "telephone_number": "650-830-5675",
            "fax_number": "650-830-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 S. NORFOLK ST.",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "94403",
            "telephone_number": "650-830-5675",
            "fax_number": "650-830-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "WALTER",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10182T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0101820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa A Wong, PHARMD
• Mark L. Wong, DC, QME
• Michael Alan Wong, D.D.S.
• Michelle Wong, PT, DPT
• Stephanie J. Wong, PH.D.
• Wesley Harry Wong
• Zachary Wong
• Allison E Woo
• Michael Woo
• Grant Ian Wood, CPO

• Optometrist in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.