Kin Yu Wong, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R4796 Issued in TX

Practice address

33203 Amberjack Dr
Richwood, TX 77515-7111

Phone

(254) 338-5067

NPI assigned

Mar 12, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

General PracticeAlso: Family Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ark HealthGroup PAC ID 4688044274, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwong458934@direct.stlukeshealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ark Health

  • Family Medicine Physician
  • Lake Jackson, TX
  • NPI 1346811452
  Medicare reassignment Care Compare group NPD Authorized official
• Health and Human Services Commission

  • Clinical Neuropsychologist
  • Harlingen, TX
  • NPI 1356414692

  General Practice

  Medicare reassignment NPD
• Health and Human Services Commission

  • Intellectual Disabilities Intermediate Care Facility
  • Corpus Christi, TX
  • NPI 1134208952

  General Practice

  NPD
• Health and Human Services Commission

  • Psychiatric Hospital
  • Big Spring, TX
  • NPI 1881600682
  NPD
• R. Kattegummula, M.D, P.a.

  • Internal Medicine Physician
  • Lake Jackson, TX
  • NPI 1417254756
  NPD (past)

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1962743229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33203 AMBERJACK DR",
            "city": "RICHWOOD",
            "state": "TX",
            "postal_code": "775157111",
            "telephone_number": "254-338-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33203 AMBERJACK DR",
            "city": "RICHWOOD",
            "state": "TX",
            "postal_code": "775157111",
            "telephone_number": "254-338-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KIN",
        "middle_name": "YU",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-12",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R4796",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "02004354A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0116025426",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debbie Hurta
• Stephanie Elizabeth Kopecky, LPC
• Maria Laws
• Anna Katherine Tucker, COTA
• Winnie-Stowell Hospital District

• Family Medicine Physician in Richwood, TX
• Providers in Richwood, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.

Verify at the official NPI Registry.