Individual provider Active NPI

Ryan J Fong, RPA-C

  • Physician Assistant
  • Quincy, MA
National Provider Identifier
1154621860
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4883 Issued in MA
Practice address
54 Miller St Ste 201
Quincy, MA 02169-4725
Phone
(617) 481-3100
Fax
(617) 481-3105
NPI assigned
Oct 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 014255 NY
Physician Assistant 363A00000X 4883 MA Primary

Addresses

Primary practice location

54 Miller St Ste 201
Quincy, MA 02169-4725

Mailing address

362 N Bedford St
East Bridgewater, MA 02333-1148
Phone (617) 481-3100

Other practice location 1

11835 Rt 9W
West Coxsackie, NY 12192-3605
Phone (518) 731-9000

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181009000414 ME Practitioner - Physician Assistant 8123203643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy HospitalGroup PAC ID 6103737812, 307 clinicians

Practice addresses (Care Compare)

144 State St
Portland, ME 04101-3776
Phone (207) 879-3190

19 S Gorham Xing
Gorham, ME 04038-2690
Phone (207) 535-1400

40 Park Rd
Westbrook, ME 04092-3188
Phone (207) 857-8174

409 Roosevelt TRL
Windham, ME 04062-4821
Phone (207) 400-8600

Hospital & facility affiliations

  • Northern Light Mercy Hospital Hospital, Portland, ME, CCN 200008

Merit-based Incentive Payment System (MIPS)

Final score
81.67 of 100Reported as group
Quality
60.7
Promoting interoperability
91
Improvement activities
40
Cost
73.8

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc Current Accepting new patients
Mercy Hospital CurrentSince Sep 9, 2018 Accepting new patients
Mercy Hospital CurrentSince Sep 9, 2018 Accepting new patients
Compass Medical PC Past Accepting new patients

Locations

362 N Bedford St
East Bridgewtr, MA 02333
Phone (508) 350-2350

8 Commerce Blvd
Middleboro, MA 02346
Phone (774) 260-9300

40 Park Rd
Westbrook, ME 04092
Phone (207) 857-8174

Organizations & group practices 5

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": "1288137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1154621860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 N BEDFORD ST",
            "city": "EAST BRIDGEWATER",
            "state": "MA",
            "postal_code": "023331148",
            "telephone_number": "617-481-3100",
            "fax_number": "617-481-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 MILLER ST STE 201",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694725",
            "telephone_number": "617-481-3100",
            "fax_number": "617-481-3105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11835 Rt 9W",
            "address_purpose": "LOCATION",
            "city": "West Coxsackie",
            "state": "NY",
            "postal_code": "121923605",
            "country_code": "US",
            "telephone_number": "518-731-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONG",
        "first_name": "RYAN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-27",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014255",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "4883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.