Individual provider Active NPI

Elisabeth Anne Wong, MD

  • Clinical Cardiac Electrophysiology Physician
  • Providence, RI
National Provider Identifier
1972093276
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
MD21450 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-5891
Fax
(401) 444-8158
NPI assigned
May 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0001X MD21450 RI Primary
Cardiovascular Disease Physician 207RC0000X 3016010 MA
Student in an Organized Health Care Education/Training Program 390200000X CT

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

15 Lasalle Square
Providence, RI 02903
Phone (401) 444-6779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20240709003736 MA Order and Referring Only - Cardiac ElectrophysiologyPractitioner - Cardiac Electrophysiology 4183979552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince Jun 9, 2024 Accepting new patients

Locations

60 Fenwood Rd
Boston, MA 02115
Phone (617) 732-5056

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1972093276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LASALLE SQUARE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02903",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5891",
            "fax_number": "401-444-8158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "ELISABETH",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "RI",
            "license": "MD21450",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "3016010",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.