Individual provider Active NPI

Kirk L. Wong, M.D.

  • Orthopaedic Hand Surgery Physician
  • Vancouver, WA
National Provider Identifier
1881634863
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
MD40677 Issued in WA
Practice address
200 NE Mother Joseph PL Ste 110
Vancouver, WA 98664-3293
Phone
(360) 254-6161
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD40677 WA
Orthopaedic Surgery Physician 207X00000X MD23597 OR
Orthopaedic Hand Surgery Physician 207XS0106X MD40677 WA Primary

Addresses

Primary practice location

200 NE Mother Joseph PL Ste 110
Vancouver, WA 98664-3293

Mailing address

200 NE Mother Joseph PL
Suite 210
Vancouver, WA 98664-3299
Phone (360) 254-6161

Other identifiers 2

IdentifierTypeStateIssuer
8294035MedicaidWA
287040MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100212000033 WA Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 2668464785 Reassigns benefits to 1 organization
I20110718000754 OR Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 2668464785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
Loma Linda University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwest Surgical Specialists PCGroup PAC ID 4183527153, 118 clinicians

Practice addresses (Care Compare)

1 N Ctr Court St
110 Rebound Sports Medicine
Portland, OR 97227-2104
Phone (503) 732-6863

200 NE Mother Joseph PL
110 Rebound Orthopedics
Vancouver, WA 98664-3293
Phone (360) 254-6161

200 NE Mother Joseph PL
Suite 210
Vancouver, WA 98664-3295

2121 NE 139TH St
300 Rebound
Vancouver, WA 98686-2316
Phone (360) 254-6161

2211 NE 139TH St
Legacy Salmon Creek Medical Center
Vancouver, WA 98686-2742
Phone (360) 487-1000

400 NE Mother Joseph PL
Peacehealth Southwest Medical Center
Vancouver, WA 98664-3200
Phone (360) 514-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)36
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD40677WAMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J and D Physical Therapy Services Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kwong21905@reboundmd.gardenplot.direct-ci.com
  • Direct secure messaging: kirk.wong.p1@direct.reboundmd.nextgenshare.com

Organizations & group practices 2

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 6

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1881634863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL",
            "address_2": "SUITE 210",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643299",
            "telephone_number": "360-254-6161",
            "fax_number": "360-449-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643293",
            "telephone_number": "360-254-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KIRK",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD40677",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "MD23597",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "WA",
            "license": "MD40677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8294035",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287040",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.