NPIMap

Individual provider Active NPI

Calbert A Wong, M.D.

  • Nephrology Physician
  • Camarillo, CA
National Provider Identifier
1902805294
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A52812 Issued in CA
Practice address
2438 N Ponderosa Dr
# C-101
Camarillo, CA 93010-2369
Phone
(805) 383-9727
Fax
(805) 764-0176
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A52812 CA Primary

Addresses

Primary practice location

2438 N Ponderosa Dr
# C-101
Camarillo, CA 93010-2369

Mailing address

4000 Calle Tecate Ste 115
Camarillo, CA 93012-5285
Phone (805) 485-2400

Other practice location 1

1900 Outlet Center Dr
Oxnard, CA 93036-0677
Phone (805) 983-8049

Other identifiers 1

IdentifierTypeStateIssuer
00A528120MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050613001377 CA Practitioner - NephrologyPractitioner - Internal Medicine 5799672838 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Tulane University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renal Consultants of Ventura County IncGroup PAC ID 1658595590, 9 clinicians

Practice addresses (Care Compare)

2438 N Ponderosa Dr
Suite C101
Camarillo, CA 93010-2465
Phone (805) 383-9727

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A52812CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Renal Consultants of Ventura County, Inc Nephrology CurrentSince May 12, 2014 Accepting new patients
County of Ventura CurrentSince May 30, 2015 Accepting new patients
Vista del Mar Medical Group, Inc Nephrology Past Accepting new patients
Dignity Health Past Accepting new patients
Simi Valley Hospital and Health Care Services Past Accepting new patients
Community Memorial Health System Past Accepting new patients
Los Robles Regional Medical Center Past Accepting new patients

Locations

4000 Calle Tecate
Ste 115
Camarillo, CA 93012
Phone (805) 485-2400

2438 N Ponderosa Dr
Ste C101
Camarillo, CA 93010
Phone (559) 664-9252

3541 W 5th St
Oxnard, CA 93030
Phone (805) 984-5435

1900 Outlet Center Dr
Oxnard, CA 93036
Phone (805) 278-3815

2125 Knoll Dr
Ste 104
Ventura, CA 93003

2705 Loma Vista Rd
Ste 101
Ventura, CA 93003
Phone (805) 383-9727

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FCFGBD
  • FHIR API: https://fhir4.healow.com/fhir/r4/FBCJAD

Organizations & group practices 8

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1902805294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 CALLE TECATE STE 115",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125285",
            "telephone_number": "805-485-2400",
            "fax_number": "805-233-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2438 N PONDEROSA DR",
            "address_2": "# C-101",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102369",
            "telephone_number": "805-383-9727",
            "fax_number": "805-764-0176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Outlet Center Dr",
            "address_purpose": "LOCATION",
            "city": "Oxnard",
            "state": "CA",
            "postal_code": "930360677",
            "country_code": "US",
            "telephone_number": "805-983-8049",
            "fax_number": "805-983-8076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "CALBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A52812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A528120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.