Randolph Wy Wong, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G76113 Issued in CA

Practice address

1501 Trousdale Dr
5TH Floor
Burlingame, CA 94010-4506

Phone

(650) 652-8787

NPI assigned

Feb 12, 2007

Last updated

Jun 19, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

General Surgery

Education

Jefferson Medical College of Thomas Jefferson University, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, shared by 16 NPIs, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Care at Home Home health agency, San Mateo, CA, CCN 058123
• Peninsula Medical Center Hospital, Burlingame, CA, CCN 050007

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 30)

Interoperability endpoints

• Direct secure messaging: mwong48216@hisp.ehr.sutterhealth.org
• Direct secure messaging: wrandolph18676@smch.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of San Mateo

  dba San Mateo Medical Center

  • Multi-Specialty Clinic/Center
  • San Mateo, CA
  • NPI 1679642326
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  dba Palo Alto Medial Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  dba Palo Alto Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Palo Alto, CA
  • NPI 1104067115
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Fremont, CA
  • NPI 1497996524
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Los Altos, CA
  • NPI 1568851327
  Medicare reassignment NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Mountain View, CA
  • NPI 1982845186
  Medicare reassignment NPD
• County of San Mateo

  dba Shasta

  • Community/Behavioral Health Agency
  • Redwood City, CA
  • NPI 1528432481
  NPD
• Sutter Bay Medical Foundation

  dba Sutter Pacific Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1003267196
  NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • San Carlos, CA
  • NPI 1164840088
  NPD
• Sutter Bay Medical Foundation

  • Ambulatory Surgical Clinic/Center
  • Fremont, CA
  • NPI 1306241534
  NPD
• Sutter Bay Medical Foundation

  dba Palo Alto Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Palo Alto Medical Foundation

  dba Sutter Sant Cruz Main 4th Floor

  • Non-Pharmacy Dispensing Site
  • Santa Cruz, CA
  • NPI 1114182649
  NPD (past)

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

• Sutter Bay Hospitals

  dba Mills-Peninsula Medical Center

  • General Acute Care Hospital
  • Burlingame, CA
  • NPI 1043670334
  Care Compare affiliation
• Sutter Bay Hospitals

  dba Menlo Park Surgical Hospital

  • General Acute Care Hospital
  • Menlo Park, CA
  • NPI 1295199701
  Care Compare affiliation
• Sutter Visiting Nurse Association and Hospice

  dba Sutter Care at Home

  • Home Health Agency
  • San Mateo, CA
  • NPI 1821027624
  Care Compare affiliation

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1811038649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "650-652-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 TROUSDALE DR",
            "address_2": "5TH FLOOR",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104506",
            "telephone_number": "650-652-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "RANDOLPH",
        "middle_name": "WY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "CA",
            "license": "G76113",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G76113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "YYY34803Y",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "G76113",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Wong
• Kwong Yiu Wong
• Marisa Kristine Wong
• Melody Wong, ND
• Morgan Wong
• Shirlin Wong, D.C.
• Stephanie Wong
• Gerald Woo
• Richard Ace Woo, D.P.M.
• Michael Kent Wood, MD

• Surgery Physician in Burlingame, CA
• Providers in Burlingame, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.