Brandon Wong, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

33602 Issued in CA

Practice address

3566 Bluelake Cir
Stockton, CA 95219-1747

Phone

(209) 470-4913

NPI assigned

Oct 25, 2016

Sex

Male

Sole proprietor

Yes

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 CA

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

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kennedy and Young OptometryGroup PAC ID 6507810967, 3 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kennedy & Young Optometry

  dba Valley Optometric Group

  • Optometrist
  • Modesto, CA
  • NPI 1912119942
  Medicare reassignment Care Compare group NPD
• Kennedy & Young Optometry

  dba Valley Optometric Group

  • Optometrist
  • Modesto, CA
  • NPI 1639744238
  NPD

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1871045955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3566 BLUELAKE CIR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952191747",
            "telephone_number": "209-470-4913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3566 BLUELAKE CIR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952191747",
            "telephone_number": "209-470-4913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "BRANDON",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia Jean Woltkamp
• Woman Owned Workforce Company, LLC (WowCo Logistics, LLC)
• Women's Center-Youth & Family Services
• Adam Wong
• Andrew Jo-Wang Wong, PH.D.
• Chai Wong
• Christian Kwanhang Wong, MD
• Clyde Yuen Wong, MD
• Darren K Wong, PHARM.D.
• Duncan Wong, RPH, PHARMD

• Optometrist in Stockton, CA
• Providers in Stockton, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.