Individual provider Active NPI

Debra Gail Wong, NP

  • Family Nurse Practitioner
  • Burlington, MA
National Provider Identifier
1720074909
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN250536 Issued in MA
Practice address
41 Mall Rd
Burlington, MA 01805-6051
Phone
(781) 744-8000
NPI assigned
Sep 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP30006318 WA
Family Nurse Practitioner 363LF0000X AP091058 ME
Family Nurse Practitioner 363LF0000X 200550145NP OR
Family Nurse Practitioner 363LF0000X RN250536 MA Primary

Addresses

Primary practice location

41 Mall Rd
Burlington, MA 01805-6051

Mailing address

PO Box 24520
New York, NY 10087-3720

Other practice location 1

820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone (509) 663-8711

Other practice location 2

1501 NE Medical Center Dr
Bend, OR 97701-6051
Phone (541) 382-4900

Other identifiers 3

IdentifierTypeStateIssuer
1720074909MedicaidWA
279021MedicaidOR
P01665533OtherWARR MEDICARE WVH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dwong21878@directmsg.bmctotalcare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA, MA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20080310000007 OR Practitioner - Nurse Practitioner 9537114970 Reassigns benefits to 1 organization
I20120522000928 WA Practitioner - Nurse Practitioner 9537114970 Reassigns benefits to 2 organizations
I20250623003712 MA Practitioner - Nurse Practitioner 9537114970 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beth Israel Lahey Health Primary Care, IncGroup PAC ID 7719291434, 351 clinicians
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN250536MAMDFamily Nurse Practitioner
AP091058MEMDFamily Nurse Practitioner
200550145NPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Whidbey Island Public Hospital District Current Accepting new patients
Lahey Clinic, Inc CurrentSince Jun 1, 2025 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Sep 12, 2025 Accepting new patients
Northwest Hospital Medicine Physicians LLC Nurse Practitioner CurrentSince Mar 15, 2019 Accepting new patients
Bend Memorial Clinic PC Nurse Practitioner Current Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Apr 1, 2012 Accepting new patients
South Sound Inpatient Physicians PLLC Nurse Practitioner CurrentSince Apr 1, 2012 Accepting new patients
Lahey Clinic, Inc. CurrentSince Jun 1, 2025 Accepting new patients
Bend Memorial Clinic PC CurrentSince May 1, 2024 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Sep 12, 2025 Accepting new patients
The Blue Hill Memorial Hospital Past Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

1 Essex Dr
Peabody, MA 01960
Phone (978) 538-4000

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

231 E Cascade Ave
Sisters, OR 97759
Phone (541) 382-4900

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

3810 Plaza Way
Kennewick, WA 99338
Phone (509) 221-7000

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

Interoperability endpoints

  • Direct secure messaging: reidll@direct.whidbeygen.org
  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4
  • Direct secure messaging: wongde@direct.whidbeygen.org

Organizations & group practices 11

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.

Hospital & facility affiliations 3

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1720074909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24520",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018056051",
            "telephone_number": "781-744-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 N Chelan Ave",
            "address_purpose": "LOCATION",
            "city": "Wenatchee",
            "state": "WA",
            "postal_code": "988012028",
            "country_code": "US",
            "telephone_number": "509-663-8711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 NE Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977016051",
            "country_code": "US",
            "telephone_number": "541-382-4900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "DEBRA",
        "middle_name": "GAIL",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-23",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30006318",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "AP091058",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200550145NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN250536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720074909",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279021",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE WVH",
            "identifier": "P01665533",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwong21878@directmsg.bmctotalcare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1501 NE Medical Center Dr",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.