Individual provider Active NPI

Doris Hwoi Shan Wong, O.D.

  • Optometrist
  • Pleasanton, CA
National Provider Identifier
1790801439
Registry record updated Apr 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13121T Issued in CA
Practice address
5580 Springdale Ave Ste E
Pleasanton, CA 94588-3707
Phone
(925) 463-3100
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13121T CA Primary

Addresses

Primary practice location

5580 Springdale Ave Ste E
Pleasanton, CA 94588-3707

Mailing address

5580 Springdale Ave Ste E
Pleasanton, CA 94588-3707
Phone (925) 463-3100

Other names 1

  • Dr. Doris H Wong Other name

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090127000594 CA Practitioner - Optometry 6901960558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doris H Wong Optometric CorporationGroup PAC ID 6507095882, 5 clinicians

Practice addresses (Care Compare)

175 Market PL
San Ramon, CA 94583-4741
Phone (925) 275-0202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13121TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Doris H Wong Optometric Corporation Optometrist CurrentSince Nov 15, 2013 Accepting new patients
Luxottica of America Inc. Past Accepting new patients

Locations

5580 Springdale Ave
Ste E
Pleasanton, CA 94588
Phone (925) 251-1682

175 Market Pl
San Ramon, CA 94583
Phone (925) 275-0202

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365811200000",
    "number": "1790801439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5580 SPRINGDALE AVE STE E",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883707",
            "telephone_number": "925-463-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5580 SPRINGDALE AVE STE E",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883707",
            "telephone_number": "925-463-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "DORIS",
        "middle_name": "HWOI SHAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2013-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13121T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DORIS",
            "last_name": "WONG",
            "middle_name": "H",
            "prefix": "DR.",
            "credential": "OD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.