Individual provider Active NPI

Marcus Ian NG, MD

  • Sports Medicine (Family Medicine) Physician
  • Aurora, CO
National Provider Identifier
1003297102
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
DR.0070419 Issued in CO
Practice address
16290 E Quincy Ave
Aurora, CO 80015-1594
Phone
(303) 338-4545
NPI assigned
Jun 15, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD463890 PA
Family Medicine Physician 207Q00000X MT208517 PA
Sports Medicine (Family Medicine) Physician 207QS0010X 300074 NY
Sports Medicine (Family Medicine) Physician 207QS0010X DR.0070419 CO Primary

Addresses

Primary practice location

16290 E Quincy Ave
Aurora, CO 80015-1594

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other practice location 1

1001 Franklin Ave Rm 110
Garden City, NY 11530-2901
Phone (516) 396-7846

Other identifiers 1

IdentifierTypeStateIssuer
029450OtherCOKAISER COMMERCIAL NUMBER

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mng6@northwell.edu Health Information Exchange (HIE)
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200423001236 NY Practitioner - Family Practice 4587979000 Reassigns benefits to 2 organizations
I20230803004179 CO Practitioner - Family PracticePractitioner - Sports Medicine 4587979000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
State University of New York at Buffalo School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Permanente Medical Group PCGroup PAC ID 1254238454, 1,325 clinicians

Practice addresses (Care Compare)

16290 E Quincy Ave
Kaiser Permante Smoky Hill Medical
Aurora, CO 80015-1594
Phone (303) 338-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
300074NYMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Apr 7, 2020 Accepting new patients
Colorado Permanente Medical Group, P.C. CurrentSince Jul 17, 2023 Accepting new patients
North Shore-Lij Medical PC Family Medicine CurrentSince Apr 7, 2020 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Sep 20, 2022 Accepting new patients

Locations

16290 E Quincy Ave
Aurora, CO 80015
Phone (303) 360-1580

10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1001 Franklin Ave
Rm 110
Garden City, NY 11530
Phone (516) 396-7846

300 Community Dr
Plandome, NY 11030

Interoperability endpoints

  • Direct secure messaging: mng2308474@nychhc.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1003297102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16290 E QUINCY AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800151594",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Franklin Ave Rm 110",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "NY",
            "postal_code": "115302901",
            "country_code": "US",
            "telephone_number": "516-396-7846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NG",
        "first_name": "MARCUS",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-15",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD463890",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT208517",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NY",
            "license": "300074",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CO",
            "license": "DR.0070419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "029450",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mng6@northwell.edu",
            "affiliation": "N",
            "endpointDescription": "Hospital Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "300 Community Dr",
            "city": "Manhasset",
            "state": "NY",
            "country_code": "US",
            "postal_code": "110303876",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "16290 E Quincy Ave",
            "city": "Aurora",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800151594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.