Individual provider Active NPI

Ryan Dong, PA

  • Medical Physician Assistant
  • New York, NY
National Provider Identifier
1023765906
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
139 Centre St PH 104
New York, NY 10013
Phone
(212) 343-2536
NPI assigned
Mar 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

139 Centre St PH 104
New York, NY 10013

Mailing address

720 57TH St Apt 4D
Brooklyn, NY 11220-3777

Other practice location 1

570 Lexington Ave Fl 9
New York, NY 10022-6710
Phone (646) 926-7277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20260204004383 NY Practitioner - Physician Assistant 8628557113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

720 57TH St
Apt 4D
Brooklyn, NY 11220-3681

720 57TH St Apt
4D
Brooklyn, NY 11220-3777

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
028582NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jian Cui, Dermatology, P.C. CurrentSince Dec 28, 2025 Accepting new patients
New York University PastSince Dec 28, 2025 Accepting new patients

Locations

6402 8th Ave
Ste 505
Brooklyn, NY 11220
Phone (718) 921-1620

13620 38th Ave
Ste 5H
Flushing, NY 11354
Phone (718) 661-1955

Organizations & group practices 2

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": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1023765906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 57TH ST APT 4D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 CENTRE ST PH 104",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10013",
            "telephone_number": "212-343-2536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "570 Lexington Ave Fl 9",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100226710",
            "country_code": "US",
            "telephone_number": "646-926-7277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONG",
        "first_name": "RYAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-09",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.