NPIMap

Individual provider Active NPI

Deborah F Wong, MD

  • General Practice Physician
  • Sonora, CA
National Provider Identifier
1952363178
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G64641 Issued in CA
Practice address
13975 Mono Way Ste G
Sonora, CA 95370-2824
Phone
(209) 533-9600
Fax
(209) 533-9608
NPI assigned
Apr 4, 2006
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G64641 CA
General Practice Physician 208D00000X G64641 CA Primary

Addresses

Primary practice location

13975 Mono Way Ste G
Sonora, CA 95370-2824

Mailing address

PO Box 939
Angels Camp, CA 95222-0939
Phone (209) 754-6262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041104001105 CA Practitioner - Family PracticePractitioner - General Practice 6002879624
I20241127000754 TX Practitioner - General PracticePractitioner - Family Practice 6002879624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of California, San Diego School of Medicine, 1987
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

13975 Mono Way
Sonora, CA 95370-2824
Phone (209) 533-9600

52 S Main St
Angels Camp, CA 95222-9153
Phone (209) 754-6262

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G64641CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
M a C T Health Board Incorporated Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: deborah.wong.p1@direct.macthealth.nextgenshare.com

Organizations & group practices 2

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1952363178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 939",
            "city": "ANGELS CAMP",
            "state": "CA",
            "postal_code": "952220939",
            "telephone_number": "209-754-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13975 MONO WAY STE G",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953702824",
            "telephone_number": "209-533-9600",
            "fax_number": "209-533-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "DEBORAH",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-04",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G64641",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G64641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

Verify at the official NPI Registry.