Individual provider Active NPI

Phuong Vinh

  • Diagnostic Radiology Physician
  • Latham, NY
National Provider Identifier
1063596872
Registry record updated Dec 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
192214 Issued in NY
Practice address
711 Troy Schenectady Rd
Suite 114
Latham, NY 12110-2442
Phone
(518) 786-1600
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 192214 NY Primary

Addresses

Primary practice location

711 Troy Schenectady Rd
Suite 114
Latham, NY 12110-2442

Mailing address

711 Troy Schenectady Rd
Suite 201
Latham, NY 12110-2442

Other identifiers 1

IdentifierTypeStateIssuer
01429450MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060224000563 NY Practitioner - Diagnostic Radiology 3476569674 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Hospital CurrentSince Jan 12, 2019 Accepting new patients
Community Care Physicians, PLLC Diagnostic Radiology CurrentSince Jan 1, 2002 Accepting new patients
Albany Medical College CurrentSince Jun 1, 2019 Accepting new patients
Albany Medical Center Hospital Diagnostic Radiology CurrentSince Jul 1, 2002 Accepting new patients
Albany Medical Center Hospital Past Accepting new patients

Locations

43 New Scotland Ave
Albany, NY 12208
Phone (518) 262-5149

47 New Scotland Ave
#113
Albany, NY 12208

1367 Washington Ave
Albany, NY 12206
Phone (518) 438-7926

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

1365 Washington Ave
Ste 103
Albany, NY 12206
Phone (518) 465-6501

25 Hackett Blvd
#201
Albany, NY 12208
Phone (518) 262-1244

47 New Scotland Ave
#139
Albany, NY 12208
Phone (518) 262-3773

71 Prospect Ave
Hudson, NY 12534
Phone (518) 262-3773

711 Troy Schenectady Rd
Ste 114
Latham, NY 12110
Phone (518) 783-7070

711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

711 Troy Schenectady Rd
Ste 201
Latham, NY 12110

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Organizations & group practices 6

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197072000000",
    "number": "1063596872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 114",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-786-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINH",
        "first_name": "PHUONG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "192214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01429450",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.