Samuel Wong, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

208297 Issued in NY

Practice address

13626 37TH Ave
Flushing, NY 11354-6533

Phone

(718) 886-1200

NPI assigned

Apr 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: swong787547@direct.ochin.org
• Direct secure messaging: sawong@1120.direct.myezyaccess.com

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.

• Charles B. Wang Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1417261298
  NPD (past)
• TJH Medical Services, P.C.

  • Internal Medicine Physician
  • Jamaica, NY
  • NPI 1184670465

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1962465278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 426",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115680426",
            "telephone_number": "516-567-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13626 37TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546533",
            "telephone_number": "718-886-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "208297",
            "primary": true
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "NY",
            "license": "208297",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02021850",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Hon Por Wong
• Mitchell J Wong, REGISTERED NURSE
• Rebecca Wong
• Sabrina Shin Lin Wong
• Sai-Kit Wong, D.O.
• Shaoyun Wong
• Sharon Wong
• Shera Wong, RN
• Shirley Wong
• Sinkong Wong, O.T

• Obstetrics & Gynecology Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.