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Deactivated NPI 1114976511 Deactivated / Inactive NPI Male Practitioner

Dr. Michael L Wong , MD

Pediatrics • Corvallis, OR

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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. Michael Wong has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 10, 2006
NPI Deactivation Date July 21, 2022
Total Practice Duration ~16 Years of Practice (2006 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Michael Wong, MD was a registered Pediatrics practicing in Corvallis, OR. Throughout an active medical career spanning 16 years, Dr. Wong provided care at the practice location at 3680 NW SAMARITAN DR until profile deactivation on 2022-07-21.

Practice Location & Contact Primary Location

Practice Address

3680 Nw Samaritan Dr

Corvallis, OR 973303737

Telephone 5417541150
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Corvallis, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 20.9 Yrs
Regional Practice Density
31 Specialists

Practicing in Corvallis, OR (880 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License OR MD10118

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Laura Luczkiw

Dietitian, Registered

NPI 1003271727
NPI 1003866294

Doctor of Philosophy (Ph.D.)

Dr. Kevin Cuccaro , DO

Anesthesiology - Pain Medicine

NPI 1003937772

Doctor of Osteopathic Medicine (D.O.)

Kourtney Hanks , CNM, FNP

Nurse Practitioner

NPI 1013371707

Certified Nurse Midwife, Family Nurse Practitioner

Dr. Gary Gray , DPT

Physical Therapist

NPI 1013968098

Doctor of Physical Therapy

John Navarro , PA-C

Physician Assistant

NPI 1023040722

Physician Assistant (Certified)

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 Deactivated July 21, 2022

Record deactivated on July 21, 2022

NPI Profile Active June 05, 2009

NPI status registered as active in NPPES database

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Updated Practice Location June 05, 2009

Registered at 3680 NW SAMARITAN DR, CORVALLIS, OR 973303737 (Tel: 5417541150)

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Updated Business Mailing Address June 05, 2009

Registered at 444 NW ELKS DR, CORVALLIS, OR 973303745

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Provider Name / Credentials Updated June 05, 2009

Recorded as MICHAEL WONG, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 05, 2009

Pediatrics (License #MD10118 in OR)

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Initial NPI Registration & Enumeration May 10, 2006

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: 1114976511
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 10, 2006
Last Update: June 05, 2009
Deactivation Date: July 21, 2022

Mailing Address

444 Nw Elks Dr

Corvallis, OR 973303745

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.