NPIMap

Individual provider Active NPI

Jenny Wong, MD

  • Family Medicine Physician
  • Coronado, CA
National Provider Identifier
1689837742
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A96793 Issued in CA
Practice address
230 Prospect PL Ste 340B
Coronado, CA 92118-1991
Phone
(619) 522-4000
Fax
(619) 435-0150
NPI assigned
Jul 8, 2008
Last updated
Jan 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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 A96793 CA Primary

Addresses

Primary practice location

230 Prospect PL Ste 340B
Coronado, CA 92118-1991

Mailing address

230 Prospect PL Ste 340B
Coronado, CA 92118-1991
Phone (619) 522-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081029000642 CA Practitioner - Family Practice 8527126903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Geffen School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sharpcare Medical Group ApcGroup PAC ID 0244518736, 23 clinicians

Practice addresses (Care Compare)

230 Prospect PL
Suite 340B
Coronado, CA 92118-1991
Phone (619) 522-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sharpcare Medical Group, Apc Family Medicine CurrentSince Oct 1, 2016 Accepting new patients
Sharp Coronado Hospital and Healthcare Center Past Accepting new patients
Grossmont Family Medical Group, Inc. Family Medicine PastSince Mar 1, 2000 Accepting new patients
Sharp Healthcare Past Accepting new patients

Locations

230 Prospect Pl
Ste 340B
San Diego, CA 92118
Phone (619) 522-4000

Interoperability endpoints

  • Direct secure messaging: jwong114226@sharphealthcare.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1689837742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 PROSPECT PL STE 340B",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181991",
            "telephone_number": "619-522-4000",
            "fax_number": "619-435-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 PROSPECT PL STE 340B",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181991",
            "telephone_number": "619-522-4000",
            "fax_number": "619-435-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "JENNY",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A96793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coronado, CA

Sources for this page

Verify at the official NPI Registry.