Individual provider Active NPI

Dallis Quang Ngo, D.O., M.S.

  • Pulmonary Disease Physician
  • Pomona, CA
National Provider Identifier
1174055149
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
20A16871 Issued in CA
Practice address
1940 N Orange Grove Ave Ste a
Pomona, CA 91767-3002
Phone
(909) 865-6900
Fax
(909) 865-6300
NPI assigned
Mar 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 2022013108 MO
Pulmonary Disease Physician 207RP1001X 20A16871 CA Primary

Addresses

Primary practice location

1940 N Orange Grove Ave Ste a
Pomona, CA 91767-3002

Mailing address

840 Towne Center Dr
Pomona, CA 91767-5900
Phone (909) 398-1550

Other practice location 1

240 Easton Ave
New Brunswick, NJ 08901-1723
Phone (000) 000-0000

Other practice location 2

625 S New Ballas Rd Ste 7020
Saint Louis, MO 63141-8218
Phone (314) 251-6486

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
I20230831003254 CA Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 3072990886 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chaparral Medical Group IncGroup PAC ID 6800709403, shared by 2 NPIs, 66 clinicians

Practice addresses (Care Compare)

1940 N Orange Grove Ave
Pomona, CA 91767-3002
Phone (909) 865-6900

8330 Red Oak St
Suite 201
Rancho Cucamonga, CA 91730-0603
Phone (909) 987-2528

Hospital & facility affiliations

  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231
  • San Antonio Regional Hospital Hospital, Upland, CA, CCN 050099

Merit-based Incentive Payment System (MIPS)

Final score
78.08 of 100Reported as group
Quality
40.87
Promoting interoperability
75
Improvement activities
40
Cost
74.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A16871CAMDPulmonary Disease Physician
16871CAMDMedical Physician Assistant
2022013108MOMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Apr 30, 2024 Accepting new patients
Chaparral Medical Group, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Chaparral Medical Group Inc. CurrentSince Aug 1, 2023 Accepting new patients
Chaparral Medical Group, Inc. CurrentSince Sep 23, 2023 Accepting new patients
Dallis Ngo DO Inc Pulmonary Disease Current Accepting new patients
Chaparral Medical Group, Inc. Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 30, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Chaparral Medical Group Inc Past Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

1801 W Olympic Blvd
Pasadena, CA 91199

840 Towne Center Dr
Pomona, CA 91767

1940 N Orange Grove Ave
Ste A
Pomona, CA 91767
Phone (909) 629-0444

1904 N Orange Grove Ave
Ste A
Pomona, CA 91767

1940 N Orange Grove Ave
Pomona, CA 91767
Phone (909) 620-8443

1866 N Orange Grove Ave
Ste 202
Pomona, CA 91767
Phone (909) 623-8796

9190 Haven Ave
Ste 101
Rancho Cucamonga, CA 91730
Phone (909) 581-6732

8330 Red Oak St
Ste 201
Rch Cucamonga, CA 91730
Phone (909) 987-1730

585 N Mountain Ave
Ste A
Upland, CA 91786
Phone (909) 608-7546

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

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": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1174055149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 TOWNE CENTER DR",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675900",
            "telephone_number": "909-398-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 N ORANGE GROVE AVE STE A",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673002",
            "telephone_number": "909-865-6900",
            "fax_number": "909-865-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Easton Ave",
            "address_purpose": "LOCATION",
            "city": "New Brunswick",
            "state": "NJ",
            "postal_code": "089011723",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "625 S New Ballas Rd Ste 7020",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631418218",
            "country_code": "US",
            "telephone_number": "314-251-6486",
            "fax_number": "314-251-4155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGO",
        "first_name": "DALLIS",
        "middle_name": "QUANG",
        "name_prefix": "Dr.",
        "credential": "D.O., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-29",
        "last_updated": "2024-10-25",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2022013108",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "20A16871",
            "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": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.