Individual provider Active NPI

Richard Duong, PA-C

  • Physician Assistant
  • Brockton, MA
National Provider Identifier
1003367335
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA5946 Issued in MA
Practice address
110 Liberty St
Brockton, MA 02301
Phone
(508) 565-3055
NPI assigned
Oct 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA5946 MA Primary

Addresses

Primary practice location

110 Liberty St
Brockton, MA 02301

Mailing address

110 Liberty St
Brockton, MA 02301-5674
Phone (508) 565-3055

Other practice location 1

15 Roche Bros Way
North Easton, MA 02356-1000
Phone (781) 344-3535

Other practice location 2

15 Roche Bros Way
North Easton, MA 02356-1000
Phone (781) 344-3535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170109000940 MA Practitioner - Physician Assistant 6002197977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA5946MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Care Physician Network LLC CurrentSince Nov 13, 2016 Accepting new patients

Locations

10 Reservoir St
Ste 101
Mansfield, MA 02048
Phone (508) 618-7111

15 Roche Brothers Way
North Easton, MA 02356
Phone (781) 545-9273

Interoperability endpoints

  • Direct secure messaging: richard.duong@direct.signature.masshiway.net
  • FHIR API: https://api.platform.athenahealth.com/13709/brand/2/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1003367335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LIBERTY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015674",
            "telephone_number": "508-565-3055",
            "fax_number": "508-894-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LIBERTY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "508-565-3055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Roche Bros Way",
            "address_purpose": "LOCATION",
            "city": "North Easton",
            "state": "MA",
            "postal_code": "023561000",
            "country_code": "US",
            "telephone_number": "781-344-3535",
            "fax_number": "508-535-0192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 Roche Bros Way",
            "address_purpose": "LOCATION",
            "city": "North Easton",
            "state": "MA",
            "postal_code": "023561000",
            "country_code": "US",
            "telephone_number": "781-344-3535",
            "fax_number": "866-388-2185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUONG",
        "first_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-21",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA5946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.