Individual provider Active NPI

Kenneth Wong

  • Physician Assistant
  • San Francisco, CA
National Provider Identifier
1992153977
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
61473 Issued in CA
Practice address
505 Parnassus Ave
San Francisco, CA 94143-2204
Phone
(407) 925-8943
NPI assigned
May 31, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 61473 CA Primary

Addresses

Primary practice location

505 Parnassus Ave
San Francisco, CA 94143-2204

Mailing address

1411 E 31St St
Oakland, CA 94602-1092
Phone (510) 437-4800

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230117002538 CA Practitioner - Physician Assistant 1951640184 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
86.93
Promoting interoperability
100
Improvement activities
40
Cost
72.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
61473CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services CurrentSince Jan 4, 2023 Accepting new patients
University of California San Francisco CurrentSince Jan 4, 2023 Accepting new patients
University of California San Francisco CurrentSince Jan 4, 2023 Accepting new patients
Tufts Medical Center, Inc. Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

3100 San Pablo Ave
Berkeley, CA 94702
Phone (510) 985-5020

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

505 Parnassus Ave
#L126
San Francisco, CA 94143
Phone (415) 353-1634

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

Interoperability endpoints

  • Direct secure messaging: kwong274070@direct-ucsfmedicalcenter.org

Organizations & group practices 7

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": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1992153977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021092",
            "telephone_number": "510-437-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204",
            "telephone_number": "407-925-8943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KENNETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-31",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "61473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.