Charles Chu-Li Wong, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

35063264W Issued in OH

Practice address

1729 Kinneys Lane
Suite 203
Portsmouth, OH 45662-3167

Phone

(740) 354-2942

Fax

(740) 353-3661

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Merit-based Incentive Payment System (MIPS)

Final score

84.04 of 100Reported as group

Quality

60.55

Promoting interoperability

100

Improvement activities

40

Cost

78.81

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cwong24882@direct.kdhealth.us
• Direct secure messaging: admin@gastroccwong.e-mdsdirect.com

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.

• Kings Daughters Medical Specialties Inc

  • Otolaryngology Physician
  • Ashland, KY
  • NPI 1497083539

  OH

  Medicare reassignment NPD
• Kings Daughters Medical Specialties Inc

  • Radiation Oncology Physician
  • Ashland, KY
  • NPI 1699565176
  NPD
• Kings Daughters Medical Specialties Inc

  • Physical Medicine & Rehabilitation Physician
  • Prestonsburg, KY
  • NPI 1710215736
  NPD

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1801890314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 KINNEYS LANE",
            "address_2": "SUITE 203",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623167",
            "telephone_number": "740-354-2942",
            "fax_number": "704-353-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 KINNEYS LANE",
            "address_2": "SUITE 203",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623167",
            "telephone_number": "740-354-2942",
            "fax_number": "740-353-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "CHARLES",
        "middle_name": "CHU-LI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "63264",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "35063264W",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0879705",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jarrett Withrow
• Amy Witter
• Kevin Wolfe, APRN
• Margaret Ellen Wolfe, LPN
• Ashley Wolfram, PA
• Karen R Wood
• Tiffany Wood, LSW
• Jack Todd Woodring
• Brandi Woods, CDCA
• Jamie L Woods

• Gastroenterology Physician in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Gastroenterology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.