Randall Vernon Wong, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

D0041207 Issued in MD

Practice address

3025 Hamaker CT
Suite 101
Fairfax, VA 22031-2237

Phone

(703) 876-9630

Fax

(703) 876-0163

NPI assigned

Jun 23, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Anh Nguyen, M.D., P.C.

  • Ophthalmology Physician
  • Falls Church, VA
  • NPI 1215962840

  DC

  Medicare reassignment NPD
• Dressler Ophthalmology Assoc PLC

  • Ophthalmology Physician
  • Fairfax, VA
  • NPI 1679540843

  DC

  Medicare reassignment NPD
• Anh Nguyen Ophthalmic Surgery LLC

  • Ambulatory Surgical Clinic/Center
  • Falls Church, VA
  • NPI 1891566840
  NPD (past)
• Optimum Optical LLC

  • Optician
  • Fairfax, VA
  • NPI 1588772024
  NPD (past)
• Katzen Medical Associates, PC

  dba National Retina Institute

  • Ophthalmology Physician
  • Lutherville, MD
  • NPI 1326052614
  NPD (past)

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1851397988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 BEE RIDGE RD",
            "address_2": "STE 200",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342397243",
            "telephone_number": "703-876-9630",
            "fax_number": "703-876-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 HAMAKER CT",
            "address_2": "SUITE 101",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312237",
            "telephone_number": "703-876-9630",
            "fax_number": "703-876-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "RANDALL",
        "middle_name": "VERNON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0041207",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0041207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497691600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jemoon Won
• Alissa Levine Wong, DNP, FNP-C
• Derek Wong, FNP-C
• Marisa Wong, FNP
• Mayin Wong, DO
• Andrew Woo, M.D.
• Molly Wood, MSN, FNP-BC
• Nicole Michelle Woodard, PSY.D.
• Alexa Josephine Woodburn
• Jennifer Woodley

• Ophthalmology Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Ophthalmology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.