Shi-Yin Wong, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G34772 Issued in CA

Practice address

407 W College Street
Los Angeles, CA 90012

Phone

(213) 626-3589

Fax

(213) 626-7868

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3368/brand/1/csg/1/fhir/r4

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.

• Shi Yin Wong MD, a Medical Corporation

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1619029964
  Medicare reassignment NPD Authorized official
• Ahmc San Gabriel Valley Medical

  dba AHMC San Gabriel Valley Medical Center

  • Skilled Nursing Facility
  • San Gabriel, CA
  • NPI 1710174818
  NPD (past)
• Dignity Health

  dba Mercy Hospital

  • General Acute Care Hospital
  • Bakersfield, CA
  • NPI 1104981661
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1902986920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 W COLLEGE STREET",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90012",
            "telephone_number": "213-626-3589",
            "fax_number": "213-626-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 W COLLEGE STREET",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90012",
            "telephone_number": "213-626-3589",
            "fax_number": "213-626-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "SHI-YIN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G34772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G347720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Lee Wong, D.D.S., M.S.
• Samuel John Wong
• SE Fum Wong, M.D.
• Severina Louise Wong
• Shek Wong
• Stacey Angela Wong, M.S., L.AC.
• Stacey Mi Wong
• Stanley S Wong, LAC
• Stephanie Wong, MD
• Stephanie Setsuko Wong, RN

• General Practice Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.