Active NPI
Stuart Wong, CRNA
- Certified Registered Nurse Anesthetist
- Rosemead, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 95001205
- Practice address
- 1060 Walnut Grove Ave Apt B
Rosemead, CA 91770-3773 - Phone
- (626) 318-7139
- NPI assigned
- Oct 9, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 95001205 | CA | Primary |
Addresses
Primary practice location
1060 Walnut Grove Ave Apt B
Rosemead, CA 91770-3773
Mailing address
1060 Walnut Grove Ave Apt B
Rosemead, CA 91770-3773
Phone (626) 318-7139
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95001205 | CA | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Single Specialty | Current | Accepting new patients |
Locations
13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
Single Specialty
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Panorama City, CA
- NPI 1407888928
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Kaiser Foundation Hospital Panorama City
- General Acute Care Hospital
- Panorama City, CA
- NPI 1376698043
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639094400000",
"number": "1881236990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1060 WALNUT GROVE AVE APT B",
"city": "ROSEMEAD",
"state": "CA",
"postal_code": "917703773",
"telephone_number": "626-318-7139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1060 WALNUT GROVE AVE APT B",
"city": "ROSEMEAD",
"state": "CA",
"postal_code": "917703773",
"telephone_number": "626-318-7139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "STUART",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-09",
"last_updated": "2021-12-10",
"certification_date": "2021-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CA",
"license": "95001205",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "13652 Cantara St",
"city": "Panorama City",
"state": "CA",
"country_code": "US",
"postal_code": "914025423",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Rosemead, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.