Rolando M Tong, MD
Individual provider Active NPI Family Medicine Physician · Chama, NM
NPI 1023006129 · NPPES record last updated Mar 29, 2013
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jun 20, 2017.
Key facts
- NPI
- 1023006129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 89-109 (NM)
- Practice address
- 2215 State Rd 17
Chama, NM 87520-0668 - Phone
- (575) 756-1030
- Fax
- (575) 756-1030
- NPI assigned
- Oct 12, 2005
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 89-109 | NM | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 89-109 | NM | Yes |
Addresses
Primary practice location
2215 State Rd 17
Chama, NM 87520-0668
Mailing address
PO Box 668
2215 State Rd 17
Chama, NM 87520-0668
Phone (575) 756-1030
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000E1435 | Medicaid | NM |
Other providers in Chama, NM
- Riverbear Counseling LLC
- Patricia Serna
- Kathleen Lesh Smith
- Tara Terrazas
- Therapeutic Solutions of New Mexico
- Jeffrey Versaw
All providers in Chama, NM · Family Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- OIG LEIE (HHS Office of Inspector General).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.