Individual provider Active NPI

Kelsey Wong

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1871260703
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14960 Issued in TX
Practice address
5223 Hamilton Wolfe Rd
San Antonio, TX 78229-4463
Phone
(210) 614-1234
NPI assigned
Aug 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14960 TX Primary

Addresses

Primary practice location

5223 Hamilton Wolfe Rd
San Antonio, TX 78229-4463

Mailing address

5223 Hamilton Wolfe Rd
San Antonio, TX 78229-4463

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20221230002142 TX Practitioner - Physician Assistant 1052781325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Medical Branch at Galveston, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5223 Hamilton Wolfe Rd
San Antonio, TX 78229-4463
Phone (210) 614-1234

5425 W Spring Creek Pkwy
Suite 205
Plano, TX 75024-4236
Phone (972) 526-5860

P O Box
Suite 35629
Dallas, TX 75235-0629

PO Box
Suite 35629
Dallas, TX 75235-0629

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
66.51
Promoting interoperability
98
Improvement activities
40
Cost
71.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants, PLLC CurrentSince Jan 1, 2023 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

5425 W Spring Creek Pkwy
Ste 205
Plano, TX 75024
Phone (972) 526-5860

5223 Hamilton Wolfe Rd
San Antonio, TX 78229
Phone 2106141234713

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1871260703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5223 HAMILTON WOLFE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5223 HAMILTON WOLFE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294463",
            "telephone_number": "210-614-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.