Tin Ha Ngoc, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD20742 Issued in ME

Practice address

575 Main St
Gorham, ME 04038-2623

Phone

(207) 839-2559

Fax

(207) 523-1135

NPI assigned

Jun 27, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ME

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5857/brand/1/csg/1/fhir/r4
• Direct secure messaging: tin.ha-ngoc.1@5857.direct.athenahealth.com

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.

• Martin'S Point Health Care, Inc.

  • Family Medicine Physician
  • Portland, ME
  • NPI 1366474611
  Medicare reassignment NPD
• Portland Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Portland, ME
  • NPI 1609120856
  Medicare reassignment
• Spectrum Healthcare Partners, P.a.

  dba Spectrum Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Portland, ME
  • NPI 1386757607
  NPD (past)

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1073877791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9746",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041045040",
            "telephone_number": "207-791-3888",
            "fax_number": "207-828-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 MAIN ST",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040382623",
            "telephone_number": "207-839-2559",
            "fax_number": "207-523-1135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HA NGOC",
        "first_name": "TIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD20742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tin.ha-ngoc.1@5857.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "575 Main St",
            "city": "Gorham",
            "state": "ME",
            "country_code": "US",
            "postal_code": "040382623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gorham Village Dental LLC
• Pamela Graves, CST AS-C
• Jacob David Gregoire
• Christopher Robert Guido, RPH
• Peter Anthony Guilfoyle, PA-C
• Hannaford Bros Co LLC (Hannaford Supermarket & Pharmacy)
• Ashley Harmon
• Kelsey Ann Harney, D.M.D.
• Laurie A. Harriman, MA SLP-CCC
• Jonathan Harvey, MD

• Family Medicine Physician in Gorham, ME
• Providers in Gorham, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.