Individual provider Active NPI

Phillip Allen Wong, D.O.

  • Family Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1952462079
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A-823-85 Issued in NM
Practice address
10211 Montgomery Blvd NE Ste a
Albuquerque, NM 87111-3608
Phone
(505) 296-8968
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X A-823-85 NM
Family Medicine Physician 207Q00000X A-823-85 NM Primary

Addresses

Primary practice location

10211 Montgomery Blvd NE Ste a
Albuquerque, NM 87111-3608

Mailing address

10211 Montgomery Blvd NE Ste a
Albuquerque, NM 87111-3608
Phone (505) 296-8968

Other names 1

  • Dr. Phillip Allen Wong Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20050202000894 NM Practitioner - Osteopathic Manipulative MedicinePractitioner - Family Practice 8628029014 Practice locations: Albuquerque, NM

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative MedicineAlso: Family Practice
Education
Other, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3620 Wyoming Blvd N E
Suite 128
Albuquerque, NM 87111-3288

3620 Wyoming Blvd NE
Suite 128
Albuquerque, NM 87111-3288
Phone (505) 296-8968

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1952462079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10211 MONTGOMERY BLVD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113608",
            "telephone_number": "505-296-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10211 MONTGOMERY BLVD NE STE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113608",
            "telephone_number": "505-296-8968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "PHILLIP",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NM",
            "license": "A-823-85",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "A-823-85",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHILLIP",
            "last_name": "WONG",
            "middle_name": "ALLEN",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.