Individual provider Active NPI

Lai Wong, CRNP

  • Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1790943835
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R165769 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-4422
Fax
(410) 328-0177
NPI assigned
May 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R165769 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

920 Elkridge Landing Rd
Linthicum, MD 21090-2917
Phone (443) 462-5010

Other identifiers 1

IdentifierTypeStateIssuer
414872000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20081013000384 MD Practitioner - Nurse Practitioner 3476621079 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

301 Hospital Dr
Glen Burnie, MD 21061-5803
Phone (410) 787-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R165769MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Community Medical Group, Inc. CurrentSince Nov 14, 2016 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Nov 14, 2016 Accepting new patients
Baltimore Washington Medical Center Inc. Current Accepting new patients
Baltimore Washington Medical Center Inc. CurrentSince Nov 3, 2014 Accepting new patients
Baltimore Washington Medical Center Inc. CurrentSince Nov 3, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

821 N Eutaw St
Ste 214
Baltimore, MD 21201
Phone (443) 552-2900

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

219 S Washington St
Easton, MD 21601

300 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4940

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

920 Elkridge Landing Rd
Linthicum Heights, MD 21090

Interoperability endpoints

  • Direct secure messaging: lwong17481@direct.umm.edu

Organizations & group practices 6

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 1

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": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1790943835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 ELKRIDGE LANDING RD",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902917",
            "telephone_number": "443-462-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-4422",
            "fax_number": "410-328-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "LAI",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-27",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R165769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "414872000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.