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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

THERESA WONG
NPI 1215469176
Internal Medicine - Geriatric Medicine in Pasadena, CA

Active since March 30, 2017Opted out of Medicare · through Mar 25, 2028
151 S EL MOLINO AVE STE 200, PASADENA, CA 91101(626) 765-5636(626) 650-1150 Get Directions Write a Review

NPPES record last updated: October 27, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Oct 27, 2026, May 11, 2024, Mar 30, 2017 (3 updates tracked since 2017).

About Theresa Wong NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THERESA WONG (NPI 1215469176) is an individual geriatric medicine provider in Pasadena, California, licensed in California (A159265) and active in the NPI registry since March 2017. She has opted out of Medicare through March 25, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1215469176
Entity TypeIndividualFemale
Primary Taxonomy207RG0300X
Provider Legal NameTHERESA WONG
Location Address151 S EL MOLINO AVE STE 200Pasadena, CA 91101-2562
Mailing Address151 S El Molino Ave Ste 200Pasadena, CA 91101-2562 · (626) 765-5636 · Fax (626) 650-1150
Phone(626) 765-5636
Fax(626) 650-1150
Sole ProprietorYes
Enumeration DateMarch 30, 2017
Last NPPES UpdateOctober 27, 20263 updates tracked since enumeration
NPPES CertifiedOctober 27, 2026
✔ NPI 1215469176 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
License✔ Licensed in CA · A159265
Definition
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
151 S EL MOLINO AVE STE 200, Pasadena, CA 91101
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Theresa Wong has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 25, 2024 through March 25, 2028.

Opt-Out Effective DateMarch 25, 2024
Opt-Out In Effect ThroughMarch 25, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91101 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$187.60 typical visit price
range $62.96 – $187.60
Typical copayment $46.90 (range $15.74 – $46.90)
Most-billed visit code 99205
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theresa Wong's NPI number?

The NPI number for Theresa Wong is 1215469176. It was assigned to this individual provider in the NPPES registry on March 30, 2017.

Where is Theresa Wong located?

Theresa Wong practices at 151 S El Molino Ave Ste 200, Pasadena, CA 91101. The listed phone number is (626) 765-5636.

What is Theresa Wong's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Is Theresa Wong enrolled in Medicare?

No. Theresa Wong has opted out of Medicare through March 25, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Theresa Wong was last updated on October 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.