Physician Compare National (NPI:1659620516)

HEALTHCARE PROVIDER: VICKY WING LAI WONG O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1659620516
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7416188008
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140325000309
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WONG
	Individual professional last name
Provider First Name	VICKY
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SHADY GROVE EYE AND VISION CARE, LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0042209231
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	15200 SHADY GROVE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	ROCKVILLE
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	208503218
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3016701212
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y