Individual provider Active NPI

Paul C Tung, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Dover, NH
National Provider Identifier
1083667141
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
7890 Issued in NH
Practice address
10 Members Way
Suite 400
Dover, NH 03820-5933
Phone
(603) 742-1143
Fax
(603) 749-3509
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 7890 NH Primary

Addresses

Primary practice location

10 Members Way
Suite 400
Dover, NH 03820-5933

Mailing address

789 Central Ave
Dover, NH 03820-2526
Phone (603) 742-1143

Other identifiers 2

IdentifierTypeStateIssuer
1083667141MedicaidME
3076045MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20050929000759 NH Practitioner - EndocrinologyPractitioner - Internal Medicine 1850294802 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation Endocrinology, Diabetes & Metabolism CurrentSince Jul 26, 1989 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Jul 26, 1989 Accepting new patients

Locations

789 Central Ave
Ofc
Dover, NH 03820
Phone (603) 740-4478

750 Central Ave
Ste Q
Dover, NH 03820
Phone (603) 742-6030

10 Members Way
Ste 400
Dover, NH 03820
Phone (603) 740-2887

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

19 Webb Pl
Dover, NH 03820
Phone (603) 742-1143

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1083667141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-742-1143",
            "fax_number": "603-749-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEMBERS WAY",
            "address_2": "SUITE 400",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038205933",
            "telephone_number": "603-742-1143",
            "fax_number": "603-749-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNG",
        "first_name": "PAUL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NH",
            "license": "7890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083667141",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3076045",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.