Individual provider Active NPI

Kristin Wong, MD

  • Internal Medicine Physician
  • Newark, NJ
National Provider Identifier
1932360112
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08907300 Issued in NJ
Practice address
140 Bergen St
Newark, NJ 07103-2425
Phone
(973) 972-1880
Fax
(973) 972-1681
NPI assigned
Jun 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA08907300 NJ
Internal Medicine Physician 207R00000X 25MA08907300 NJ Primary

Addresses

Primary practice location

140 Bergen St
Newark, NJ 07103-2425

Mailing address

140 Bergen St
Newark, NJ 07103-2425
Phone (973) 972-1880

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kwong20041@direct.uhnj.org Direct University Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20130923000531 NJ Practitioner - Internal MedicinePractitioner - Pediatric Medicine 6800030339 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

140 Bergen St
Newark, NJ 07103-2425
Phone (973) 972-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08907300NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc Internal Medicine CurrentSince Aug 1, 2013 Accepting new patients
Rwjbh Primary Care Services Internal Medicine CurrentSince Feb 12, 2024 Accepting new patients
University Hospital Past Accepting new patients
University Physician Associates of New Jersey Inc Past Accepting new patients
Newark Beth Israel Medical Center Inc Past Accepting new patients

Locations

25 Kilmer Dr
Ste 107
Morganville, NJ 07751
Phone (732) 385-5262

150 Bergen St
#H245
Newark, NJ 07103
Phone (973) 972-5672

30 Bergen St
Rm 1205
Newark, NJ 07107
Phone (973) 972-0037

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

140 Bergen St
Newark, NJ 07103
Phone (973) 972-0320

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

90 Bergen St
Newark, NJ 07103
Phone (973) 972-0037

8 Mountain Blvd
Ste J
Warren, NJ 07059
Phone (732) 893-0200

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 1

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": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1932360112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-1880",
            "fax_number": "973-972-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-1880",
            "fax_number": "973-972-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA08907300",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08907300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwong20041@direct.uhnj.org",
            "affiliation": "Y",
            "endpointDescription": "Epic",
            "affiliationName": "University Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "150 Bergen St",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071032496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.