Ryan Wong, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A106001 Issued in CA

Practice address

230 S Main St
Suite 100
Orange, CA 92868-3851

Phone

(714) 541-0101

Fax

(714) 541-0450

NPI assigned

Jun 11, 2007

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

Electronic endpoints 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

Specialty

Plastic and Reconstructive Surgery

Education

Northwestern University Feinberg Medical School, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Regents of the University of California

  • Plastic Surgery Physician
  • San Diego, CA
  • NPI 1326141862
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Regents of the University of California

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1558463927
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1316463763
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Lancaster, CA
  • NPI 1982863783
  NPD
• Hospital Service District No. 2

  • Critical Access Hospital
  • Breaux Bridge, LA
  • NPI 1548263262
  NPD (past)
• Nes Louisiana Inc

  • Emergency Medicine Physician
  • Franklinton, LA
  • NPI 1407161250
  NPD (past)

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1912101452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 S MAIN ST",
            "address_2": "SUITE 100",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683851",
            "telephone_number": "714-541-0101",
            "fax_number": "714-541-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S MAIN ST",
            "address_2": "SUITE 100",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683851",
            "telephone_number": "714-541-0101",
            "fax_number": "714-541-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "RYAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A106001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katrina Wong, DPT
• Nicholas Wong
• Pammie Wong, PHARM.D.
• Philip Y Wong, MD
• Rachael Sze Nga Wong
• Siu-Fun Wong, PHARM.D.
• Susan Wong, M.D.
• Tammy Wong
• Shannon Wongvibulsin
• Dustin Woo

• Plastic Surgery Physician in Orange, CA
• Providers in Orange, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.