Individual provider Active NPI

Jean F. Wong, MD

  • Urology Physician
  • Meriden, CT
National Provider Identifier
1891988648
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
048139 Issued in CT
Practice address
455 Lewis Ave
Suite 210
Meriden, CT 06451-2121
Phone
(203) 238-1241
Fax
(203) 686-0791
NPI assigned
Aug 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 048139 CT Primary

Addresses

Primary practice location

455 Lewis Ave
Suite 210
Meriden, CT 06451-2121

Mailing address

455 Lewis Ave
Suite 210
Meriden, CT 06451-2121
Phone (203) 238-1241

Other identifiers 17

IdentifierTypeStateIssuer
048139OtherCTCONNECTICARE
06-1406459OtherCTUNITED HEALTHCARE
06-1406459OtherCTTRICARE
06-1406459OtherCTPIONEER
1891988648MedicaidCT
P4179178OtherCTOXFORD
06-1406459OtherCTCOMMUNITY HEALTH NETWORK
06-1406459OtherCTPRIVATE HEALTHCARE SYSTEMS
1891988648OtherCTAETNA
1891988648OtherCTANTHEM BCBS
57294OtherCTWELLCARE
06-1406459OtherCTMULTIPLAN
06-1406459OtherCTHEALTH NEW ENGLAND
3V6324OtherCTHEALTH NET
06-1406459OtherCTNORTHEAST HEALTH DIRECT
06-1406459OtherCTCORVEL
9048959OtherCTCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100828000047 CT Practitioner - Urology 1456475409 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
State University of New York Downstate Medical Center, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

455 Lewis Ave
Meriden, CT 06451-2121
Phone (203) 694-8808

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
048139CTMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Urology CurrentSince Jun 1, 2019 Accepting new patients
Hartford Healthcare Medical Group, Inc Urology CurrentSince Jan 1, 2013 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2019 Accepting new patients
Neighborhood Health, Inc. Past Accepting new patients
Hartford Clinical Associates, P.C. Urology Past Accepting new patients

Locations

85 Seymour St
Ste 301
Hartford, CT 06106
Phone (860) 696-2030

85 Seymour St
Ste 416
Hartford, CT 06106
Phone (860) 522-4158

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

455 Lewis Ave
Ste 210
Meriden, CT 06451
Phone (203) 238-1241

330 Washington St
Ste 350
Norwich, CT 06360
Phone (860) 886-1956

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

540 Litchfield St
Torrington, CT 06790
Phone (860) 496-6361

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: jean.wong@xdr.hhchealthdirect.org

Organizations & group practices 5

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 8

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": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1891988648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 LEWIS AVE",
            "address_2": "SUITE 210",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512121",
            "telephone_number": "203-238-1241",
            "fax_number": "203-686-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 LEWIS AVE",
            "address_2": "SUITE 210",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512121",
            "telephone_number": "203-238-1241",
            "fax_number": "203-686-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "JEAN",
        "middle_name": "F.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-24",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CT",
            "license": "048139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "048139",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIONEER",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891988648",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P4179178",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH NETWORK",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEMS",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1891988648",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "1891988648",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "57294",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "3V6324",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTHEAST HEALTH DIRECT",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORVEL",
            "identifier": "06-1406459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9048959",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.