Deactivated NPI 1184875759 Deactivated / Inactive NPI Male Practitioner

Dr. Johnson Kar Tsun Wong , MD

Internal Medicine • Sonora, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Johnson Wong has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 23, 2005

NPI Deactivation Date August 21, 2008

Total Practice Duration ~3 Years of Practice (2005 – 2008)

Professional Overview & Biography Verified Profile Summary

Dr. Johnson Wong, MD was a registered Internal Medicine practicing in Sonora, CA. Throughout an active medical career spanning 3 years, Dr. Wong provided care at the practice location at 14568A MONO WAY until profile deactivation on 2008-08-21.

Historical Medicare Part B clinical services included annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, established patient outpatient office visit, telephone medical discussion with physician. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

14568a Mono Way

Sonora, CA 953708858

Telephone 2097681217

Fax 2095332061

Associated Practice Facility / Clinic

🏢 Solo Internal Medicine Facility NPI 1902057573

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Sonora, CA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 27.5 Yrs

State Avg: 26.6 Yrs

Regional Practice Density

20 Specialists

Practicing in Sonora, CA (18502 Statewide)

Telehealth Adoption Rate

15.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

13.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	107	107	$172.90	$137.66
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	57	53	$140.96	$134.89
99213 Established patient office or other outpatient visit, typically 15 minutes	32	28	$111.88	$95.10

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	224	224	$160.00	$114.49
99213 Established patient office or other outpatient visit, typically 15 minutes	147	103	$87.99	$76.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	141	103	$127.66	$110.16
99442 Telephone medical discussion with physician, 11-20 minutes	17	15	$75.00	$72.72
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	11	11	$188.64	$164.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	270	270	$160.00	$114.95
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	229	156	$120.00	$109.40
99213 Established patient office or other outpatient visit, typically 15 minutes	219	139	$85.00	$74.84
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	15	15	$185.00	$163.73
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	11	11	$240.00	$206.37

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	320	320	$160.00	$113.67
99213 Established patient office or other outpatient visit, typically 15 minutes	310	185	$85.00	$71.55
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	181	136	$120.00	$105.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	397	232	$85.00	$73.28
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	322	322	$160.00	$115.17
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	214	163	$120.00	$107.57
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	50	50	$200.00	$163.54
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	23	23	$240.00	$204.76
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	15	15	$185.00	$164.41

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License CA G79608

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

00G796080 (CA)

Commercial Insurance / Payer ID Provider Tax Id#

72-1325399 (CA)

Commercial Insurance / Payer ID Group Id#

ZZZ04982Z

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

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NPI Profile Active October 01, 2008

NPI status registered as active in NPPES database

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Updated Practice Location October 01, 2008

Registered at 14568A MONO WAY, SONORA, CA 953708858 (Tel: 2097681217)

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Updated Business Mailing Address October 01, 2008

Registered at 14568A MONO WAY, SONORA, CA 953708858 (Tel: 2097681217)

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Provider Name / Credentials Updated October 01, 2008

Recorded as JOHNSON WONG, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 01, 2008

Internal Medicine (License #G79608 in CA)

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NPI Profile Deactivated August 21, 2008

Record deactivated on August 21, 2008

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Initial NPI Registration & Enumeration September 23, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1184875759

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 23, 2005

Last Update: October 01, 2008

Deactivation Date: August 21, 2008

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

14568a Mono Way

Sonora, CA 953708858

Phone: 2097681217

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.