NPIMap

Organization Active NPI

Raymond Fong M.D., P.C.

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1083619274
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
150422-1 Issued in NY
Legal business name
RAYMOND FONG M.D., P.C.
Practice address
109 Lafayette St
FL 4
New York, NY 10013-4138
Phone
(212) 274-1900
Fax
(212) 274-0738
NPI assigned
Jun 15, 2005
Last updated
Nov 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Authorized official

Name
Dr. Raymond Fong, M.D.NPI 1730181868
Title
President
Phone
(212) 274-1900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 150422-1 NY Primary

Addresses

Primary practice location

109 Lafayette St
FL 4
New York, NY 10013-4138

Mailing address

109 Lafayette St
FL 4
New York, NY 10013-4138
Phone (212) 274-1900

Other identifiers 1

IdentifierTypeStateIssuer
01949366MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040109000256 NY Part B Supplier - Clinic/Group Practice 5496655292 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
Practice locations: Flushing, NY; New York, NY; Brooklyn, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Raymond Fong MD PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320796800000",
    "number": "1083619274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 LAFAYETTE ST",
            "address_2": "FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134138",
            "telephone_number": "212-274-1900",
            "fax_number": "212-274-0738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 LAFAYETTE ST",
            "address_2": "FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134138",
            "telephone_number": "212-274-1900",
            "fax_number": "212-274-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMOND FONG M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2011-11-09",
        "status": "A",
        "authorized_official_last_name": "FONG",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-274-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "150422-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01949366",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.