Individual provider Active NPI

Linda Rose Wong, O.D.

  • Optometrist
  • Honolulu, HI
National Provider Identifier
1891835377
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD 197 Issued in HI
Practice address
1580 Makaloa St 950
Honolulu, HI 96814-3258
Phone
(808) 591-1566
Fax
(808) 593-1566
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD 197 HI Primary

Addresses

Primary practice location

1580 Makaloa St 950
Honolulu, HI 96814-3258

Mailing address

1580 Makaloa St
Suite 950
Honolulu, HI 96814-3237
Phone (808) 591-1566

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20051026000352 HI Practitioner - Optometry 3476598319 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD 197HIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Inspired Vision, LLC Optometrist CurrentSince Jun 27, 2021 Accepting new patients
Hawaii Foot Clinic, LLC PastSince May 1, 2005 Accepting new patients

Locations

1580 Makaloa St
Ste 950
Honolulu, HI 96814
Phone (808) 591-1566

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.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1891835377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 MAKALOA ST",
            "address_2": "SUITE 950",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143237",
            "telephone_number": "808-591-1566",
            "fax_number": "808-593-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 MAKALOA ST 950",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143258",
            "telephone_number": "808-591-1566",
            "fax_number": "808-593-1566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "LINDA",
        "middle_name": "ROSE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "OD 197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.