Jacky Kin Wai Kong, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

4689 Issued in MA

Practice address

940 Commonwealth Ave
Boston
Boston, MA 02215-1203

Phone

(617) 262-2020

NPI assigned

Jul 27, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Optometry

Education

New England College of Optometry, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boston Children's Hospital Hospital, Boston, MA, CCN 223302

Medicare enrollment (NPD)

Enrolled

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.

• Cambridge Eye Group Inc

  • Optometrist
  • Cambridge, MA
  • NPI 1235688557
  Medicare reassignment NPD Authorized official
• Internal Medical Associates-Ebnhc

  • Community Health Clinic/Center
  • East Boston, MA
  • NPI 1558481879
  Medicare reassignment NPD
• Neighborhealth Corporation

  • Community Health Clinic/Center
  • East Boston, MA
  • NPI 1316994411
  Medicare reassignment NPD
• Cambridge Eye Group Inc

  • Clinic/Center
  • Belmont, MA
  • NPI 1710674221
  NPD Authorized official
• Children's Hospital Corporation

  dba Boston Children's Hospital

  • Children's Hospital
  • Boston, MA
  • NPI 1710087127
  Medicare reassignment

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

• Children's Hospital Corporation

  dba Boston Children's Hospital

  • Children's Hospital
  • Boston, MA
  • NPI 1710087127
  Care Compare affiliation

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

{
    "created_epoch": "1217116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1851556021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 COMMONWEALTH AVE APT 22",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021343207",
            "telephone_number": "617-818-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 COMMONWEALTH AVE",
            "address_2": "BOSTON",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022151203",
            "telephone_number": "617-262-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "JACKY",
        "middle_name": "KIN WAI",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-27",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4689",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MA",
            "license": "4689",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sri Meghana Konda, MD
• Jordan Kondo
• Svetlana Kondratiev, MD
• Rayees Ahmed Konduru, MD
• Edward Kong, MD, PHD
• Michelle Thezin Kong, OD
• Nathalee Kong, MD
• Laura Maria Konieczna
• Karon Margaret Konner, MSW
• Nellie Konnikov, MD

• Optometrist in Boston, MA
• Providers in Boston, MA by specialty
• Optometrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; 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.