Individual provider Active NPI

Katy K Wong, M.D.

  • Rheumatology Physician
  • Bloomington, IL
National Provider Identifier
1942286760
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
036110197 Issued in IL
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, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040408000737 IL Practitioner - RheumatologyPractitioner - Internal Medicine 4082607577 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
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
Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

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

OrganizationSpecialtyStatusNew patients
Carle Health Medical Group CurrentSince Oct 4, 2025 Accepting new patients
Carle West Physician Group Inc CurrentSince Jul 1, 2020 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 5

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": "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

Verify at the official NPI Registry.