Thai Son Dang, DO

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

25MB11790500 Issued in NJ

Practice address

700 US Highway 46 Ste 420
Fairfield, NJ 07004-1532

Phone

(973) 882-3456

NPI assigned

Apr 5, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, NC, NY, SD, VA, NJ, SC, GA, PA, DC, CT, DE12 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 12

Specialty

Neurology

Education

Lake Erie College of Osteopathic Medicine, Erie, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neurophysiologic Interpretive Medicine PLLCGroup PAC ID 2567617616, 12 clinicians

Neurophysiologic Interpretive Specialists LLCGroup PAC ID 5496933657, 11 clinicians

Neuroshield Network SE LLCGroup PAC ID 7719243492, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
• Conway Medical Center Hospital, Conway, SC, CCN 420049
• Virginia Hospital Center Hospital, Arlington, VA, CCN 490050
• Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
• HCA Florida South Tampa Hospital Hospital, Tampa, FL, CCN 100206

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

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

• Neurophysiologic Interpretive Medicine PLLC

  • Neurology Physician
  • Fairfield, NJ
  • NPI 1316256167

  NY

  Medicare reassignment Care Compare group NPD
• Neurophysiologic Interpretive Specialists LLC

  • Neurology Physician
  • Fairfield, NJ
  • NPI 1780827162

  CT, DC, DE, PA

  Medicare reassignment Care Compare group NPD
• Neuroshield Network SE LLC

  dba Neuroshield Network, LLC

  • Clinical Neurophysiology Physician
  • Fairfield, NJ
  • NPI 1538600606

  FL, GA, NC, SC, SD, VA

  Medicare reassignment Care Compare group
• New York City Health and Hospitals Corporation

  dba Jacobi Medical Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1679587679
  NPD (past)

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

• Conway Hospital, Inc

  dba CMC ENT

  • Otolaryngology Physician
  • Conway, SC
  • NPI 1760459028

  Hospital

  Care Compare affiliation
• Conway Hospital, Inc.

  dba CMC Weight Loss

  • Surgery Physician
  • Conway, SC
  • NPI 1043977200

  Hospital

  Care Compare affiliation
• Conway Hospital, Inc.

  dba CMC Primary Care Church Street

  • Internal Medicine Physician
  • Conway, SC
  • NPI 1073219325

  Hospital

  Care Compare affiliation
• Conway Hospital, Inc.

  dba Conway Medical Center

  • General Acute Care Hospital
  • Conway, SC
  • NPI 1134172000
  Care Compare affiliation
• Conway Hospital, Inc.

  dba CMC Acute Care Rehab

  • Rehabilitation Hospital Unit
  • Conway, SC
  • NPI 1154991487
  Care Compare affiliation
• Conway Hospital, Inc.

  dba CMC Embrace Hospice

  • Community Based Hospice Care Agency
  • Conway, SC
  • NPI 1164121935

  Hospital

  Care Compare affiliation
• Conway Hospital, Inc.

  dba CMC Orthopaedics

  • Orthopaedic Surgery Physician
  • Conway, SC
  • NPI 1316221500

  Hospital

  Care Compare affiliation
• Conway Hospital, Inc.

  dba CMC Primary Care Myrtle Trace

  • Family Medicine Physician
  • Conway, SC
  • NPI 1548573322

  Hospital

  Care Compare affiliation
• Conway Hospital, Inc.

  dba CMC Primary Care Bellamy Avenue

  • Family Medicine Physician
  • Murrells Inlet, SC
  • NPI 1548963853

  Hospital

  Care Compare affiliation
• Conway Hospital, Inc.

  dba CMC Surgical Associates

  • Surgery Physician
  • Conway, SC
  • NPI 1649742321

  Hospital

  Care Compare affiliation
• Conway Hospital, Inc.

  dba CMC Primary Care Conway

  • Family Medicine Physician
  • Conway, SC
  • NPI 1659762227

  Hospital

  Care Compare affiliation
• Conway Hospital, Inc.

  dba CMC Primary Care Towne Center

  • Family Medicine Physician
  • Myrtle Beach, SC
  • NPI 1902047277

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1023514122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DR",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624800",
            "telephone_number": "714-791-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 US HIGHWAY 46 STE 420",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070041532",
            "telephone_number": "973-882-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANG",
        "first_name": "THAI",
        "middle_name": "SON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AL",
            "license": "DO.3252",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "OS20102",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "322669",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2023-00671",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "2084N0400X",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SD",
            "license": "14252",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0102207846",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MB11790500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Liza Cristobal, RNFA
• Criticare Medical Supplies, LLC
• CVS Caremark Specialty Pharmacy
• Bozenna Czaplinska
• Sweta G Dalsania, PA-C
• Marissa Dantonio
• Yelena Daysudov, RPH
• Cali M Defilippo
• Laura Del Tufo, LPC
• Jane C Dellert, PHD, RN, APN-C

• Neurology Physician in Fairfield, NJ
• Providers in Fairfield, NJ by specialty
• Neurology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.