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

Active since March 30, 2017Opted out of Medicare · through Mar 25, 2028
800 FAIRMOUNT AVE, PASADENA, CA 91105(626) 765-5636 Get Directions Write a Review

NPPES record last updated: May 11, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 11, 2024, Mar 30, 2017 (2 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 Address800 FAIRMOUNT AVEPasadena, CA 91105-3150
Mailing Address621 Camino CerradoSouth Pasadena, CA 91030-4103
Phone(626) 765-5636
Sole ProprietorYes
Enumeration DateMarch 30, 2017
Last NPPES UpdateMay 11, 20242 updates tracked since enumeration
NPPES CertifiedMay 11, 2024
✔ 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.
800 FAIRMOUNT AVE, Pasadena, CA 91105
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 91105 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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RUBY BATIN M.D.
Pediatrics
800 FAIRMOUNT AVE, STE 110
PASADENA, CA 91105
Los Angeles County (626) 795-7051
DR. JASON REGINALD SPEARS D.D.S.
Dentist
800 FAIRMOUNT AVE, SUITE 203
PASADENA, CA 91105
Los Angeles County (626) 792-1344
MAGDALENA C ARENAS MD
Internal Medicine (Pulmonary Disease)
800 FAIRMOUNT AVE
PASADENA, CA 91105
Los Angeles County (626) 449-1199
MARK POWELL MD
Pediatrics
800 FAIRMOUNT AVE, SUITE 415
PASADENA, CA 91105
Los Angeles County (626) 449-8440
CHRISTIAAN P HALLMAN M.D.
Dermatology
800 FAIRMOUNT AVE, SUITE 310
PASADENA, CA 91105
Los Angeles County (626) 795-2007
MICHAEL PAUL MILLER, MD, INC.
Ophthalmology
800 FAIRMOUNT AVE, SUITE 101
PASADENA, CA 91105
Los Angeles County (626) 585-8700
LISA P. URIBE, M.D., INC.
Internal Medicine
800 FAIRMOUNT AVE, SUITE 210
PASADENA, CA 91105
Los Angeles County (626) 243-2221
MELINDA MEDEIROS NP
Nurse Practitioner (Acute Care)
800 FAIRMOUNT AVE, SUITE 220
PASADENA, CA 91105
Los Angeles County (626) 486-0181

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 800 Fairmount Ave, Pasadena, CA 91105. 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 May 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.