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MS. SALLY KIM WONG PA-C
NPI 1922105584
Physician Assistant - Surgical in Vallejo, CA

Active since September 17, 2006PECOS EnrolledAccepts Medicare Assignment
975 SERENO DR, VALLEJO, CA 94589(707) 651-3470(707) 651-3484 Get Directions Write a Review

NPPES record last updated: January 3, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ms. Sally Kim Wong Pa-c NPPES

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

MS. SALLY KIM WONG PA-C (NPI 1922105584) is an individual surgical provider in Vallejo, California, licensed in California (PA15971) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2001).

NPPES Registry Identity

NPI1922105584
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameMS. SALLY KIM WONGCredential: PA-C
Location Address975 SERENO DRVallejo, CA 94589-2441
Mailing Address975 Sereno DrVallejo, CA 94589-2441 · (707) 651-3470 · Fax (707) 651-3484
Phone(707) 651-3470
Fax(707) 651-3484
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateSeptember 17, 2006
Last NPPES UpdateJanuary 3, 2022
✔ NPI 1922105584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in CA · PA15971
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA15971 (CA)
975 SERENO DR, Vallejo, CA 94589
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Sally Kim Wong Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5193908820
PECOS Enrollment IDI20110317000736
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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. ROBERTA YIWUN WANG M.D.
Physical Medicine & Rehabilitation
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-5128
RIHONG ZHOU
Pharmacist
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-2072
EVAN HIRSCHBEIN
Student in an Organized Health Care Education/Training Program
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 339-2074
MS. JEAN BROADNAX LCSW
Social Worker (Clinical)
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-4423
SEAN NISAM
Student in an Organized Health Care Education/Training Program
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-4071
LI M. TSANG MD
Anesthesiology
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-1000
DONN R. ERICKSON MD
Family Medicine
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-1000
JOHN S. WOOD MD
Surgery
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-1000

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 Sally Wong's NPI number?

The NPI number for Sally Wong is 1922105584. It was assigned to this individual provider in the NPPES registry on September 17, 2006.

Where is Sally Wong located?

Sally Wong practices at 975 Sereno Dr, Vallejo, CA 94589. The listed phone number is (707) 651-3470.

What is Sally Wong's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Sally Wong enrolled in Medicare?

Yes. Sally Wong is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Sally Wong was last updated on January 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.