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GRANGER B WONG M D INC
NPI 1609922962
Plastic Surgery in Roseville, CA

Active since January 26, 2007
576 N SUNRISE AVE, SUITE 120, ROSEVILLE, CA 95661(916) 791-7088(916) 791-7088 Get Directions Write a Review

NPPES record last updated: July 1, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Granger B Wong M D Inc NPPES

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

GRANGER B WONG M D INC (NPI 1609922962) is a healthcare organization registered as a plastic surgery in Roseville, California and active in the NPI registry since January 2007. The organization lists Granger Wong, President, as its authorized official.

NPPES Registry Identity

NPI1609922962
Entity TypeOrganization
Primary Taxonomy208200000X
Legal Business NameGRANGER B WONG M D INC
Location Address576 N SUNRISE AVE, SUITE 120Roseville, CA 95661-2841
Mailing Address576 N Sunrise Ave, Suite 120Roseville, CA 95661-2841 · (916) 791-7088 · Fax (916) 791-6606
Phone(916) 791-7088
Fax(916) 791-7088
Organization SubpartNo
Authorized OfficialGranger WongPresident · (916) 791-7088
Enumeration DateJanuary 26, 2007
Last NPPES UpdateJuly 1, 2015
✔ NPI 1609922962 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in CA · A54333
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
576 N SUNRISE AVE, Roseville, CA 95661
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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 and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Granger B Wong M D Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Granger B Wong M D Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Granger Wong, MD,DMD,FACS
Plastic and Reconstructive Surgery
NPI 1225013790
2221 STOCKTON BLVD
Sacramento, CA 95817
(916) 734-2130
✔ PECOS✔ Accepts Medicare18 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Granger B Wong M D Inc's NPI number?

The NPI number for Granger B Wong M D Inc is 1609922962. It was assigned to this organization in the NPPES registry on January 26, 2007.

Where is Granger B Wong M D Inc located?

Granger B Wong M D Inc is located at 576 N Sunrise Ave Suite 120, Roseville, CA 95661. The listed phone number is (916) 791-7088.

What is Granger B Wong M D Inc's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Granger B Wong M D Inc enrolled in Medicare?

Yes. Granger B Wong M D Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Granger B Wong M D Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Granger B Wong M D Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Granger B Wong M D Inc was last updated on July 1, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.