Mark Wong, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

32916 Issued in AZ

Practice address

1441 N 12TH St
Phoenix, AZ 85006-2837

Phone

(602) 521-5800

Fax

(602) 521-5334

NPI assigned

Apr 25, 2006

Last updated

Dec 2, 2016By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

GastroenterologyAlso: Internal Medicine

Education

Loma Linda University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Banner - University Super Specialists LLCGroup PAC ID 1850695255, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Banner - University Super Specialists LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1740650555
  Medicare reassignment Care Compare group NPD
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1821368218
  Medicare reassignment NPD
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Page, AZ
  • NPI 1366799355
  NPD
• Banner -- University Medical Center Phoenix Campus Internal Medicine

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1124071162
  NPD (past)

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

• Banner - University Medical Center Phoenix

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1841224870
  Care Compare affiliation

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1821054081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-521-5800",
            "fax_number": "602-521-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-521-5800",
            "fax_number": "602-521-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "32916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870304",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Carmine Wong, M.D.
• Karen K. Wong, M.D.
• Katie Wong
• Kit Richard Wong, D.O.
• Mark Wong, PHARM.D.
• Michael Joseph Wong, DDS
• Nathan Wong
• Priscilla Wong
• Richard Wong, DO
• Sarah Wong, FNP

• Internal Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; 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.