San Wong, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APRN9232935 Issued in FL

Practice address

8380 Riverwalk Park Blvd Ste 100
Fort Myers, FL 33919-8758

Phone

(239) 343-9960

NPI assigned

Feb 21, 2018

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012
• Gulf Coast Medical Center Lee Health Hospital, Fort Myers, FL, CCN 100220
• Cape Coral Hospital Hospital, Cape Coral, FL, CCN 100244

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: swong109633@direct.leememorial.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.

• Lee Health System Inc

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1942058557
  Medicare reassignment Care Compare group NPD
• Inpatient Consultants of Florida, Inc

  • Internal Medicine Physician
  • Orange Park, FL
  • NPI 1396795597
  Medicare reassignment NPD
• Joint Implant Surgeons of Florida PA

  • Pain Medicine (Anesthesiology) Physician
  • Fort Myers, FL
  • NPI 1508872839
  Medicare reassignment NPD
• Lee Memorial Health System

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1992873319
  Medicare reassignment NPD
• Inpatient Consultants of Florida Inc

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1457511164
  NPD
• Inpatient Consultants of Florida, Inc

  • Hospitalist Physician
  • Clearwater, FL
  • NPI 1811179831
  NPD
• Joint Implant Surgeons of Florida PA

  • Orthopaedic Surgery Physician
  • Naples, FL
  • NPI 1184196628
  NPD
• Lee Health System Inc

  • Community/Retail Pharmacy
  • Bonita Springs, FL
  • NPI 1699510925
  NPD
• Lee Memorial Health System

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD
• Lee Memorial Health System

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
  • NPI 1770165920
  NPD

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

• Lee Health System Inc

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1366281750
  Care Compare affiliation
• Lee Health System Inc

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1427806025
  Care Compare affiliation
• Lee Health System Inc

  • General Acute Care Hospital
  • Cape Coral, FL
  • NPI 1780429076
  Care Compare affiliation

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1972003499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-3800",
            "fax_number": "232-343-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 RIVERWALK PARK BLVD STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339198758",
            "telephone_number": "239-343-9960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2780 Cleveland Ave Ste 819",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "33901",
            "country_code": "US",
            "telephone_number": "239-343-3800",
            "fax_number": "239-343-3993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "SAN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-21",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "FL",
            "license": "APRN9232935",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9232935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024233400",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swong109633@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mai Vu Won, MD
• Wonderland Speech & Behavior Corp
• Hailon Wong
• Leighann S Wong, PH.D.
• Patrick LS Wong, PT, DPT
• Alika Wood
• Bailey Matthew Wood, LMT
• Laura Nicole Wood, ARNP
• Malissa J Wood, MD
• Tina Wood, APRN

• Adult Health Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.