Individual provider Active NPI

Kit Yue Wong, M.D.

  • Psychiatry Physician
  • Medway, MA
National Provider Identifier
1811964968
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
217301 Issued in MA
Practice address
163 Main St Ste 6D
Medway, MA 02053-1533
Phone
(617) 599-4746
Fax
(617) 848-2620
NPI assigned
Mar 7, 2006
Last updated
Jul 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 217301 MA Primary

Addresses

Primary practice location

163 Main St Ste 6D
Medway, MA 02053-1533

Mailing address

163 Main St Ste 6D
Medway, MA 02053-1533
Phone (617) 599-4746

Other practice location 1

1968 Central Ave
Needham, MA 02492
Phone (781) 292-2108

Other identifiers 1

IdentifierTypeStateIssuer
110126670AMedicaidMA

Other names 1

  • Kit Yue Wong Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2014 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Walker, Inc. PastSince Jan 24, 2022 Accepting new patients
Cambridge Public Health Commission Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1811964968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 MAIN ST STE 6D",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531533",
            "telephone_number": "617-599-4746",
            "fax_number": "617-848-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 MAIN ST STE 6D",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531533",
            "telephone_number": "617-599-4746",
            "fax_number": "617-848-2620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1968 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Needham",
            "state": "MA",
            "postal_code": "02492",
            "country_code": "US",
            "telephone_number": "781-292-2108",
            "fax_number": "781-455-6837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "KIT YUE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "217301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110126670A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIT YUE",
            "last_name": "WONG",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Medway, MA

Sources for this page

Verify at the official NPI Registry.