Active NPI
Karl Wong, M.D.
- Anesthesiology Physician
- Du Bois, PA
National Provider Identifier
1760580260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD-037091Y
- Practice address
- 100 Hospital Ave
Du Bois, PA 15801-1440 - Phone
- (814) 375-3286
- Fax
- (814) 375-3384
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD-037091Y | PA | Primary |
Addresses
Primary practice location
100 Hospital Ave
Du Bois, PA 15801-1440
Mailing address
PO Box 447
Du Bois, PA 15801-0447
Phone (814) 375-3286
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0009646330004 | Medicaid | PA | |
| 000013308 | Other | PA | BLUE CROSS/BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-037091Y | PA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303689600000",
"number": "1760580260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 447",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158010447",
"telephone_number": "814-375-3286",
"fax_number": "814-375-3384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HOSPITAL AVE",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158011440",
"telephone_number": "814-375-3286",
"fax_number": "814-375-3384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "KARL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2011-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "PA",
"license": "MD-037091Y",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0009646330004",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "000013308",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Du Bois, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.