Individual provider Active NPI

Ngoc Tram Dang

  • Physician Assistant
  • Warner Robins, GA
National Provider Identifier
1114534492
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1601 Watson Blvd
Warner Robins, GA 31093-3431
Phone
(478) 922-4281
NPI assigned
Sep 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X GA Primary

Addresses

Primary practice location

1601 Watson Blvd
Warner Robins, GA 31093-3431

Mailing address

1601 Watson Blvd
Warner Robins, GA 31093-3431
Phone (478) 922-4281

Other practice location 1

625 Old Peachtree Rd NW
Suwanee, GA 30024-2937
Phone (770) 682-2364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20211102001722 GA Practitioner - Physician Assistant 4486042918 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aga, LLCGroup PAC ID 2365431350, 138 clinicians
Aga Professional Services LLCGroup PAC ID 3870768997, 175 clinicians

Practice addresses (Care Compare)

2520 Windy Hill Rd SE
Suite 102
Marietta, GA 30067-8633
Phone (770) 612-8165

301 Philip Blvd
Suite a
Lawrenceville, GA 30046-8746
Phone (770) 822-5560

488 Kennesaw Ave NW
Suite 200
Marietta, GA 30060-9409
Phone (770) 427-3075

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.39 of 100Reported as group
Quality
44.91
Promoting interoperability
98
Improvement activities
40
Cost
71.38

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Emergency Group, LLC CurrentSince Oct 7, 2021 Accepting new patients

Locations

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1114534492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WATSON BLVD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933431",
            "telephone_number": "478-922-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WATSON BLVD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933431",
            "telephone_number": "478-922-4281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 Old Peachtree Rd NW",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300242937",
            "country_code": "US",
            "telephone_number": "770-682-2364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANG",
        "first_name": "NGOC TRAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.