Individual provider Active NPI

Yvonne CHI Wong, OD

  • Optometrist
  • Lakewood, NJ
National Provider Identifier
1750853412
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00685100 Issued in NJ
Practice address
159 E Kennedy Blvd
Lakewood, NJ 08701-1308
Phone
(732) 860-7505
Fax
(732) 363-2750
NPI assigned
Dec 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00685100 NJ Primary

Addresses

Primary practice location

159 E Kennedy Blvd
Lakewood, NJ 08701-1308

Mailing address

12 Trevor PL
Matawan, NJ 07747-9745
Phone (609) 613-2669

Other practice location 1

6780 US Highway 9
Howell, NJ 07731-3361
Phone (609) 613-2669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20221206002523 NJ Practitioner - Optometry 5294104766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00685100NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Howell Eye Center LLC Optometrist CurrentSince Aug 15, 2022 Accepting new patients

Locations

6780 US Highway 9
Howell, NJ 07731
Phone (609) 613-2669

159 E Kennedy Blvd
Lakewood, NJ 08701
Phone (732) 363-0880

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1750853412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 TREVOR PL",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077479745",
            "telephone_number": "609-613-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 E KENNEDY BLVD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011308",
            "telephone_number": "732-860-7505",
            "fax_number": "732-363-2750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6780 US Highway 9",
            "address_purpose": "LOCATION",
            "city": "Howell",
            "state": "NJ",
            "postal_code": "077313361",
            "country_code": "US",
            "telephone_number": "609-613-2669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "YVONNE",
        "middle_name": "CHI",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00685100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.