Jennifer Wong, RPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0162071 Issued in NY

Practice address

1800 Rockaway Ave
Suite 100
Hewlett, NY 11557-1665

Phone

(516) 887-4343

NPI assigned

Nov 15, 2012

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

Other identifiers 1

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology PCGroup PAC ID 3274526850, 67 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: jwong@advderm.emadirect.md

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.

• Advanced Dermatology PC

  • Dermatology Physician
  • New Hyde Park, NY
  • NPI 1134201460
  Medicare reassignment Care Compare group
• Anthony Buglino DO PLLC

  • Plastic Surgery Physician
  • Woodbury, NY
  • NPI 1730582834
  NPD (past)
• Dermatologic Surgery of Lexington Ave PC

  • Specialist
  • New York, NY
  • NPI 1831417468
  NPD (past)
• Howard D. Solomon, DO, PC

  • Procedural Dermatology Physician
  • Forest Hills, NY
  • NPI 1598054520
  NPD (past)

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1871837906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 ROCKAWAY AVE",
            "address_2": "SUITE 100",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571665",
            "telephone_number": "516-887-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ROCKAWAY AVE",
            "address_2": "SUITE 100",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115571665",
            "telephone_number": "516-887-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "JENNIFER",
        "name_prefix": "Miss",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0162071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101399488339",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Levi Welton, PA-C
• Fruma Leah Wiederman, PA-C
• Williamsburg Medical of New York LLC
• Jessica Wilson
• Ranan Chaim Wolff, DDS
• Kathleen Wozniak, CCC-SLP
• Alicia Wright
• Rozalina Yakubova
• Brittney C Yearsley
• Yoza Corp (Hewlett Neighborhood Pharmacy)

• Physician Assistant in Hewlett, NY
• Providers in Hewlett, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; 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.