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Deactivated NPI 1457345563 Deactivated / Inactive NPI Male Practitioner

Dr. Randy Lai Yuu Wong , OD

Optometrist • Edmonds, WA

✓ Accepts Medicare Assignment
⚠️

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

Registration / Start Date September 02, 2005
NPI Deactivation Date March 24, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Randy Wong, OD was a registered Optometrist in Edmonds, WA. Prior to record deactivation on 2006-03-24, Dr. Wong completed approximately 1 years of clinical practice following graduation from University Of California - School Of Optometry in 2005.

Dr. Wong accepted Medicare assignment.

Historical Medicare Part B clinical services included visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's, established patient outpatient office visit, extended color vision examination. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

22511 Highway 99
Ste 112

Edmonds, WA 980268398

Telephone 4256709888
Fax 4256702402
Associated Practice Facility / Clinic
🏢 Visionaire, Llc Facility NPI 1922123124

Medicare Profile & Education

Medical School

University Of California - School Of Optometry

Graduation Year

2005

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Edmonds, WA

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
21 Yrs -8.0 yrs vs City Avg
City Avg: 29.0 Yrs
State Avg: 20.4 Yrs
Regional Practice Density
11 Specialists

Practicing in Edmonds, WA (1692 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
38.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wong (21 Years) 21 Yrs
Edmonds Specialty Average (29.0 Years) 29.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's
24 17 $60.00 $16.17
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
17 13 $180.00 $128.35
92283 Extended color vision examination
16 13 $85.00 $55.09

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License WA OD00003999

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
2033587 (WA)

Career & Practice History Timeline

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

8 Historical Events
📍
Updated Practice Location January 15, 2019

Registered at 22511 HIGHWAY 99, STE 112, EDMONDS, WA 980268398 (Tel: 4256709888)

📍
Updated Practice Location August 26, 2015

Registered at 13550 AURORA AVE N, SEATTLE, WA 981337512 (Tel: 2064176920)

📍
Updated Business Mailing Address August 26, 2015

Registered at 22511 HIGHWAY 99 112, EDMONDS, WA 980268398 (Tel: 4256709888)

👤
Provider Name / Credentials Updated August 26, 2015

Recorded as RANDY WONG, O.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 26, 2015

Optometrist (License #OD00003999 in WA)

🔄
NPI Profile Reactivated April 06, 2006

Record officially reactivated for active practice on April 06, 2006

⚠️
NPI Profile Deactivated March 24, 2006

Record deactivated on March 24, 2006

🟢
Initial NPI Registration & Enumeration September 02, 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: 1457345563
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 02, 2005
Last Update: January 15, 2019
Deactivation Date: March 24, 2006
Sole Proprietor: Yes

Mailing Address

22511 Highway 99 112

Edmonds, WA 980268398

Phone: 4256709888

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.