Individual provider Active NPI

Ling Fang Guo, DO

  • Internal Medicine Physician
  • Hamden, CT
National Provider Identifier
1164059317
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
77683 Issued in CT
Practice address
2560 Dixwell Ave Ste 2B
Hamden, CT 06514-1852
Phone
(203) 230-2546
NPI assigned
Mar 26, 2020
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 77683 CT Primary

Addresses

Primary practice location

2560 Dixwell Ave Ste 2B
Hamden, CT 06514-1852

Mailing address

2560 Dixwell Ave Ste 2B
Hamden, CT 06514-1852
Phone (203) 230-2546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20241205000614 CT Practitioner - Internal Medicine 0648672410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Physicians PCGroup PAC ID 1355246950, 214 clinicians

Practice addresses (Care Compare)

2560 Dixwell Ave
Suite 2B
Hamden, CT 06514-1852
Phone (203) 230-2546

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77683CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Physicians PC Internal Medicine CurrentSince Oct 7, 2024 Accepting new patients

Locations

3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200

2560 Dixwell Ave
Ste 2B
Hamden, CT 06514
Phone (203) 230-0700

115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1164059317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 DIXWELL AVE STE 2B",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065141852",
            "telephone_number": "203-230-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 DIXWELL AVE STE 2B",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065141852",
            "telephone_number": "203-230-2546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUO",
        "first_name": "LING FANG",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "77683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.