Tan Lin Wong, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A50496 Issued in CA

Practice address

2100 Foothill Blvd Ste a
La Verne, CA 91750-2905

Phone

(909) 596-1941

Fax

(909) 596-1943

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Internal MedicineAlso: Family Practice

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ideal Choice Home Health Home health agency, Sherman Oaks, CA, CCN 559710
• Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: tanwong.248.5888@securemailmdscloud.mdsynergy.com
• Direct secure messaging: tanwong@lavernemedical.officeally.direct

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.

• La Verne Family Medical Center Inc

  • Family Medicine Physician
  • La Verne, CA
  • NPI 1457469884
  Medicare reassignment NPD Authorized official
• Goodfaith Family Medical Group

  • Primary Care Clinic/Center
  • Rosemead, CA
  • NPI 1952323800
  Medicare reassignment NPD
• Ahmc San Gabriel Valley Medical

  • Skilled Nursing Facility
  • San Gabriel, CA
  • NPI 1710174818
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ideal Choice Home Health

  • Home Health Agency
  • Sherman Oaks, CA
  • NPI 1508452376
  Care Compare affiliation
• Pomona Valley Hospital Medical Center

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1407813660
  Care Compare affiliation

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388793600000",
    "number": "1790728749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 FOOTHILL BLVD STE A",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502905",
            "telephone_number": "909-596-1941",
            "fax_number": "909-596-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 FOOTHILL BLVD STE A",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502905",
            "telephone_number": "909-596-1941",
            "fax_number": "909-596-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "TAN",
        "middle_name": "LIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A50496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083450",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "W20443",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A504961",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Macarthur Williams Jr.
• Sharon Deantte Williams, LPT
• Lilia Carreon Willis
• Donte Witherspoon
• Josephine Wong
• Woodward Chiropractic Inc.
• Gary Woodward, D.C.
• Cristal Workman
• Cristina Wucetich, MFTI
• Jason Yonemoto, MPT

• Internal Medicine Physician in La Verne, CA
• Providers in La Verne, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.