Individual provider Active NPI

Ronald D Wong, M.D.

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1710926233
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
J5950 Issued in TX
Practice address
102 Palo Alto Rd
Suite 125
San Antonio, TX 78211-3758
Phone
(210) 924-7158
Fax
(210) 924-4642
NPI assigned
Jun 6, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X J5950 TX Primary

Addresses

Primary practice location

102 Palo Alto Rd
Suite 125
San Antonio, TX 78211-3758

Mailing address

11765 West Ave
PMB 192
San Antonio, TX 78216-2559
Phone (210) 924-7158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20041018000121 TX Practitioner - Internal Medicine 8426018144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

102 Palo Alto Rd
Suite 125
San Antonio, TX 78211-3792
Phone (210) 924-7158

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J5950TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South San Antonio Medical Associates Internal Medicine CurrentSince Aug 1, 1998 Accepting new patients
VHS San Antonio Partners LLC Past Accepting new patients

Locations

102 Palo Alto Rd
Ste 125
San Antonio, TX 78211
Phone (210) 924-7158

11765 West Ave
San Antonio, TX 78216

11765 West Ave
#192
San Antonio, TX 78216
Phone (210) 977-8888

11765 West Ave
Ste 192
San Antonio, TX 78216
Phone (210) 227-9408

2207 S Zarzamora St
San Antonio, TX 78207
Phone (210) 212-2266

Organizations & group practices 2

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 1

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1710926233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11765 WEST AVE",
            "address_2": "PMB 192",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782162559",
            "telephone_number": "210-924-7158",
            "fax_number": "210-924-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PALO ALTO RD",
            "address_2": "SUITE 125",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782113758",
            "telephone_number": "210-924-7158",
            "fax_number": "210-924-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "RONALD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J5950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.