Individual provider Active NPI

Vinson Vong, MD

  • Emergency Medicine Physician
  • Riverside, CA
National Provider Identifier
1164050043
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A179194 Issued in CA
Practice address
4445 Magnolia Ave
Riverside, CA 92501-4135
Phone
(951) 788-3537
NPI assigned
Mar 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A179194 CA Primary

Addresses

Primary practice location

4445 Magnolia Ave
Riverside, CA 92501-4135

Mailing address

4445 Magnolia Ave
Riverside, CA 92501-4135
Phone (951) 788-3537

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220301002647 CA Practitioner - Emergency MedicinePractitioner - Internal Medicine 6507250933 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palomar Emergency Physicians, IncGroup PAC ID 9830593730, 71 clinicians

Practice addresses (Care Compare)

15615 Pomerado Rd
Poway, CA 92064-2405
Phone (310) 379-2134

Hospital & facility affiliations

  • Kaiser Foundation Hospital - South Bay Hospital, Harbor City, CA, CCN 050411
  • Palomar Health Downtown Campus Hospital, Escondido, CA, CCN 050115
  • Palomar Medical Center Poway Hospital, Poway, CA, CCN 050636
  • Kaiser Foundation Hospital, Riverside Hospital, Riverside, CA, CCN 050686

Merit-based Incentive Payment System (MIPS)

Final score
95.47 of 100Reported as group
Quality
85.24
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Encinitas Emergency Medicine, Inc. Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 4, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince May 25, 2024 Accepting new patients
Palomar Emergency Physicians, Inc Emergency Medicine CurrentSince Jun 15, 2023 Accepting new patients
KND Development 59, LLC CurrentSince Feb 1, 2022 Accepting new patients
KND Development 59 LLC Current Accepting new patients
KND Development 59, LLC CurrentSince Feb 1, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 4, 2023 Accepting new patients

Locations

354 Santa Fe Dr
Encinitas, CA 92024
Phone (760) 230-2251

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

550 N Monterey Ave
Ontario, CA 91764
Phone (909) 629-2290

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

15615 Pomerado Rd
Poway, CA 92064
Phone (858) 613-4000

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

Interoperability endpoints

  • Direct secure messaging: vvong150445@direct.llu.edu

Organizations & group practices 8

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 4

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": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1164050043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014135",
            "telephone_number": "951-788-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014135",
            "telephone_number": "951-788-3537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONG",
        "first_name": "VINSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A179194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.