Shirley Wong, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA059382 Issued in PA

Practice address

1401 Fairmont St
Whitehall, PA 18052-6015

Phone

(610) 432-4122

NPI assigned

Oct 6, 2017

Last updated

Oct 6, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Optum Urgent Care PLLCGroup PAC ID 8628299518, 68 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swong56000@direct.optum.com
• Direct secure messaging: shirley.wong.1@24989.direct.athenahealth.com

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.

• Optum Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Jericho, NY
  • NPI 1285975797
  Medicare reassignment Care Compare group
• Optum Medical Care, P.C.

  dba CareMount Medical, P.C.

  • Cardiovascular Disease Physician
  • Mount Kisco, NY
  • NPI 1982643003
  Medicare reassignment
• Optum Medical Care, P.C.

  • Durable Medical Equipment & Medical Supplies
  • New Hyde Park, NY
  • NPI 1053190595
  NPD

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507248000000",
    "number": "1851801617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 KINGSBRIDGE LN",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181039275",
            "telephone_number": "610-390-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 FAIRMONT ST",
            "city": "WHITEHALL",
            "state": "PA",
            "postal_code": "180526015",
            "telephone_number": "610-432-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "SHIRLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2017-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA059382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitehall Dental Group LLC
• Whitehall Medical Associates, LLC
• Whitehall-Coplay School District
• Mary Ellen Williams, D.O.
• Margaret Disalvi Wolf, OT/L
• Y2 Home Care LLC
• Yacoub Inc (Whitehall Family Dentistry)
• Nidal Yacoub, D.M.D, M.D.S
• Wael Yacoub, M.D
• Jennifer Yenser, OTR L

• Medical Physician Assistant in Whitehall, PA
• Providers in Whitehall, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2017; 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.