Individual provider Active NPI

Thy Ngoc Minh Dang, MD

  • Internal Medicine Physician
  • Brighton, MA
National Provider Identifier
1174185094
Registry record updated Oct 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
294963 Issued in MA
Practice address
77 Warren St
Brighton, MA 02135-3601
Phone
(617) 562-5250
Fax
(617) 562-5277
NPI assigned
Jul 1, 2019
Last updated
Oct 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2022

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 294963 MA Primary

Addresses

Primary practice location

77 Warren St
Brighton, MA 02135-3601

Mailing address

77 Warren St
Brighton, MA 02135-3601
Phone (617) 562-5250

Other practice location 1

736 Cambridge St
Brighton, MA 02135-2907
Phone (617) 789-3000

Other names 1

  • Ngoc Minh Thy Dang Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20221013001630 MA Practitioner - Internal Medicine 9335515592 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Revere Medical of Massachusetts PCGroup PAC ID 0749715795, 113 clinicians

Practice addresses (Care Compare)

77 Warren St
Revere Medical Health Care at Brighton Mari
Brighton, MA 02135-3683
Phone (617) 562-5525

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
294963MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steward St. Elizabeth's Medical Center of Boston, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Revere Medical of Massachusetts, PC Internal Medicine CurrentSince Dec 21, 2024 Accepting new patients
Steward St. Elizabeth's Medical Center of Boston, Inc. CurrentSince Sep 1, 2022 Accepting new patients

Locations

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

77 Warren St
Brighton, MA 02135
Phone (617) 254-1271

77 Warren St
Fl 1
Brighton, MA 02135
Phone (617) 562-5200

15 Payson Rd
Ste 3
Foxboro, MA 02035
Phone (508) 772-1438

Interoperability endpoints

  • Direct secure messaging: ndang252488@direct.bmc.masshiway.net
  • Direct secure messaging: thy.dang.1@32866.direct.athenahealth.com
  • Direct secure messaging: thy.dang.2@2017.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665187200000",
    "number": "1174185094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 WARREN ST",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353601",
            "telephone_number": "617-562-5250",
            "fax_number": "617-562-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WARREN ST",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353601",
            "telephone_number": "617-562-5250",
            "fax_number": "617-562-5277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "736 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021352907",
            "country_code": "US",
            "telephone_number": "617-789-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANG",
        "first_name": "THY",
        "middle_name": "NGOC MINH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2022-10-08",
        "certification_date": "2022-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "294963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NGOC MINH THY",
            "last_name": "DANG",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.