Jonathan Tak-Keung Wong, MD.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

222453 Issued in NY

Practice address

1 Brookdale Plaza
Brooklyn, NY 11212

Phone

(718) 240-4387

Fax

(718) 780-4703

NPI assigned

Mar 30, 2006

Last updated

Feb 4, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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 Surgery

Education

Virginia Commonwealth University, School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaiser Foundation Hospital - Walnut Creek Hospital, Walnut Creek, CA, CCN 050072

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Surgery

  Medicare reassignment Care Compare group NPD
• Total Health at Lich

  • Surgery Physician
  • Brooklyn, NY
  • NPI 1457306680
  NPD Authorized official
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510

  Surgery

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Lich Faculty Practice

  dba LICH Faculty Practice Psychiatric Associates

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1841457967
  NPD (past)
• Lichfpp Physicians

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1184670556
  NPD (past)
• State of New York

  dba Suny DMC @ Lich-Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Brooklyn, NY
  • NPI 1639477979
  NPD (past)
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  NPD (past)
• Suny Health Science Center at Brooklyn

  dba Suny DMC@Lich-Urology

  • Urology Physician
  • Brooklyn, NY
  • NPI 1104124379
  NPD (past)

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

• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Walnut Creek

  • General Acute Care Hospital
  • Walnut Creek, CA
  • NPI 1639244262
  Care Compare affiliation

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1982665840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLAZA",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11212",
            "telephone_number": "718-240-6387",
            "fax_number": "718-780-4703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLAZA",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11212",
            "telephone_number": "718-240-4387",
            "fax_number": "718-780-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "JONATHAN",
        "middle_name": "TAK-KEUNG",
        "name_prefix": "Mr.",
        "credential": "MD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "222453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4501 Sand Creek Road",
            "city": "Antioch",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jason Wong
• Jem Wong, LMFT
• Jessica Venessa Wong
• Johnny K Wong
• Jonathan Wong
• Joyce Wong, NP
• Juan S Wong
• Kaitlyn Lin Wong, M.D
• Karen Wong, MD
• Kenneth Wong, RPH

• Surgery Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.