Individual provider Active NPI

Arthur Y Wong, O.D.

  • Optometrist
  • Edmonds, WA
National Provider Identifier
1811098262
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3276 Issued in WA
Practice address
402 Main St
Edmonds, WA 98020-3138
Phone
(425) 771-7772
Fax
(425) 775-9973
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3276 WA Primary

Addresses

Primary practice location

402 Main St
Edmonds, WA 98020-3138

Mailing address

402 Main St
Edmonds, WA 98020-3138
Phone (425) 771-7772

Other identifiers 2

IdentifierTypeStateIssuer
2024966MedicaidWA
0149513OtherWAL&I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20080408000242 WA Practitioner - Optometry 4688751126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edmonds Vision Center, P.S., Inc.Group PAC ID 3971693599, 2 clinicians

Practice addresses (Care Compare)

201 5TH Ave S
Suite 102
Edmonds, WA 98020-3646
Phone (425) 771-7772

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3276WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Edmonds Vision Center PS Inc Optometrist CurrentSince Jun 1, 2007 Accepting new patients

Locations

201 5th Ave S
Ste 102
Edmonds, WA 98020
Phone (425) 771-7772

402 Main St
Edmonds, WA 98020
Phone (425) 771-7772

Organizations & group practices 1

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811098262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 MAIN ST",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203138",
            "telephone_number": "425-771-7772",
            "fax_number": "425-775-9973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 MAIN ST",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203138",
            "telephone_number": "425-771-7772",
            "fax_number": "425-775-9973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "ARTHUR",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2024966",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0149513",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.