Individual provider Active NPI

Corrie Wong

  • Physical Medicine & Rehabilitation Physician
  • Northridge, CA
National Provider Identifier
1821670530
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
300000 Issued in CA
Practice address
11260 Wilbur Ave Ste 101
Northridge, CA 91326-2450
Phone
(818) 832-5656
NPI assigned
Apr 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 300000 CA Primary

Addresses

Primary practice location

11260 Wilbur Ave Ste 101
Northridge, CA 91326-2450

Mailing address

912 N Cordova St
Alhambra, CA 91801-1107
Phone (626) 808-7414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210616003633 CA Practitioner - Physical Therapist in Private Practice 0345640090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11260 Wilbur Ave
Suite 101
Northridge, CA 91326-2450
Phone (818) 832-5656

19000 Hawthorne Blvd
Suite 300
Torrance, CA 90503-1517
Phone (310) 793-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
California Rehabilitation & Sports Therapy a California Physical Ther Current Accepting new patients
California Rehab and Sports Therapy CurrentSince Apr 26, 2021 Accepting new patients
California Rehab & Sports Therapy CurrentSince Apr 26, 2021 Accepting new patients
California Rehabilitation & Sports Therapy a California Physical Ther Past Accepting new patients
California Rehabilitation and Sports Therapy a California Physical Ther Past Accepting new patients

Locations

415 Carmen Dr
Camarillo, CA 93010
Phone (805) 322-9083

2035 Corte del Nogal
Ste 200
Carlsbad, CA 92011
Phone (760) 931-8310

11260 Wilbur Ave
Ste 101
Porter Ranch, CA 91326
Phone (818) 832-5656

19000 Hawthorne Blvd
Ste 300
Torrance, CA 90503
Phone (310) 793-1800

Organizations & group practices 5

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": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1821670530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 N CORDOVA ST",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918011107",
            "telephone_number": "626-808-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11260 WILBUR AVE STE 101",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913262450",
            "telephone_number": "818-832-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "CORRIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "300000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.