Individual provider Active NPI

T. Joe Wongananda

  • Podiatrist
  • Glen Burnie, MD
National Provider Identifier
1982786844
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
01281 Issued in MD
Practice address
806 Landmark Dr
Suite 128 - 129
Glen Burnie, MD 21061-4966
Phone
(443) 926-9147
Fax
(443) 926-9151
NPI assigned
Oct 19, 2006
Last updated
May 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 01281 MD Primary

Addresses

Primary practice location

806 Landmark Dr
Suite 128 - 129
Glen Burnie, MD 21061-4966

Mailing address

806 Landmark Dr
Suite 128 - 129
Glen Burnie, MD 21061-4966
Phone (443) 926-9147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070323000036 MD Practitioner - Podiatry 3173627635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

806 Landmark Dr
128 129
Glen Burnie, MD 21061-4980
Phone (443) 926-9147

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue236
Removal of skin lesions1-10
Removal of nail tissue2558
Removal or shaving of skin growth230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01281MDMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
T Joe Wongananda DPM PA Podiatrist CurrentSince Nov 1, 2006 Accepting new patients

Locations

806 Landmark Dr
#128129
Glen Burnie, MD 21061
Phone (443) 926-9147

806 Landmark Dr
Ste 128
Glen Burnie, MD 21061
Phone (443) 926-9147

Interoperability endpoints

  • Direct secure messaging: twongananda24507@direct.umm.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1982786844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 LANDMARK DR",
            "address_2": "SUITE 128 - 129",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614966",
            "telephone_number": "443-926-9147",
            "fax_number": "443-926-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 LANDMARK DR",
            "address_2": "SUITE 128 - 129",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614966",
            "telephone_number": "443-926-9147",
            "fax_number": "443-926-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONGANANDA",
        "first_name": "T.",
        "middle_name": "JOE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "01281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.