Individual provider Active NPI

Stanley NG, M.D.

  • Pediatrics Physician
  • Concord, CA
National Provider Identifier
1164800959
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A155274 Issued in CA
Practice address
2299 Bacon St Ste 7
Concord, CA 94520-2046
Phone
(925) 676-6500
NPI assigned
May 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A155274 CA Primary

Addresses

Primary practice location

2299 Bacon St Ste 7
Concord, CA 94520-2046

Mailing address

2299 Bacon St Ste 7
Concord, CA 94520-2046
Phone (925) 676-6500

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
I20220316000870 CA Practitioner - Pediatric Medicine 3476842162 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A155274CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North East Medical Services Current Accepting new patients
North East Medical Services CurrentSince Apr 1, 2022 Accepting new patients
North East Medical Services CurrentSince Apr 1, 2022 Accepting new patients

Locations

211 Eastmoor Ave
Daly City, CA 94015
Phone (650) 550-3923

82 Leland Ave
San Francisco, CA 94134
Phone (415) 391-9688

1520 Stockton St
San Francisco, CA 94133

1450 Noriega St
San Francisco, CA 94122

1870 Lundy Ave
San Jose, CA 95131
Phone (408) 573-9686

Interoperability endpoints

  • Direct secure messaging: sng18859@northeastmedicalservicesnems.direct-ci.com

Organizations & group practices 3

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": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1164800959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2299 BACON ST STE 7",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202046",
            "telephone_number": "925-676-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2299 BACON ST STE 7",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202046",
            "telephone_number": "925-676-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NG",
        "first_name": "STANLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-12",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A155274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.