Active NPI
Katy K Wong, M.D.
- Rheumatology Physician
- Bloomington, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 036110197
- Practice address
- 1401 Eastland Dr
Bloomington, IL 61701-3552 - Phone
- (309) 663-8311
- Fax
- (309) 661-3390
- NPI assigned
- Dec 22, 2005
- Last updated
- Mar 28, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 036110197 | IL | Primary |
Addresses
Primary practice location
1401 Eastland Dr
Bloomington, IL 61701-3552
Mailing address
611 W. Park St
Fapc
Urbana, IL 61801
Other practice location 1
3024 E Empire St
Bloomington, IL 61704-5402
Phone (309) 268-3900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Rheumatology
- Education
- University of Hawaii John a. Burns School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1302 Franklin Ave
Suite 3400
Normal, IL 61761-6523
Phone (309) 556-8295
2204 Eastland Dr
Bloomington, IL 61704-3567
Phone (309) 663-0222
3024 E Empire St
Bloomington, IL 61704-5402
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carle Health Medical Group | Current | Accepting new patients | |
| Carle West Physician Group Inc | Current | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
1401 Eastland Dr
Bloomington, IL 61701
Phone (309) 661-3360
2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461
3024 E Empire St
Bloomington, IL 61704
Phone (309) 556-7500
3310 Fields South Dr
Champaign, IL 61822
Phone (217) 902-5300
911 S Chestnut St
Le Roy, IL 61752
Phone (309) 365-8608
1304 Franklin Ave
Normal, IL 61761
Phone (309) 268-3590
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- kwongmd323058@carlehiedirect.net
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Carle Physician Group
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
-
- Family Medicine Physician
- Normal, IL
- NPI 1467074138
-
dba Gibson Area Hospital and Health Services
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Advocate BroMenn Medical Center
- General Acute Care Hospital
- Normal, IL
- NPI 1962424036
-
dba Advocate Eureka Hospital
- Critical Access Hospital
- Eureka, IL
- NPI 1184644023
-
dba OSF Saint Elizabeth Medical Center
- General Acute Care Hospital
- Peru, IL
- NPI 1588713440
-
dba Osf Saint James-John W Albrecht Medical Center
- General Acute Care Hospital
- Pontiac, IL
- NPI 1407808090
-
dba OSF Saint Joseph Medical Center
- General Acute Care Hospital
- Bloomington, IL
- NPI 1619916806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648425600000",
"number": "1942286760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 W. PARK ST",
"address_2": "FAPC",
"city": "URBANA",
"state": "IL",
"postal_code": "61801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 EASTLAND DR",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617013552",
"telephone_number": "309-663-8311",
"fax_number": "309-661-3390"
}
],
"practiceLocations": [
{
"address_1": "3024 E Empire St",
"address_purpose": "LOCATION",
"city": "Bloomington",
"state": "IL",
"postal_code": "617045402",
"country_code": "US",
"telephone_number": "309-268-3900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WONG",
"first_name": "KATY",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-22",
"last_updated": "2022-03-28",
"certification_date": "2021-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "IL",
"license": "036110197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; 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.