Individual provider Active NPI

Ronald George Dong, M.D.

  • Otolaryngology Physician
  • Stockton, CA
National Provider Identifier
1194764472
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G87118 Issued in CA
Practice address
10200 Trinity Pkwy Ste 201
Stockton, CA 95219-7288
Phone
(209) 952-0483
Fax
(209) 478-5785
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G87118 CA Primary

Addresses

Primary practice location

10200 Trinity Pkwy Ste 201
Stockton, CA 95219-7288

Mailing address

1111 Exposition Blvd
BLDG 700
Sacramento, CA 95815-4314
Phone (916) 736-3408

Other practice location 1

801 S Ham Ln Ste O
Lodi, CA 95242-7502
Phone (209) 952-0483

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
I20040923001007 CA Practitioner - Otolaryngology 7618945999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10200 Trinity Pkwy
Suite 201
Stockton, CA 95219-7288
Phone (209) 952-0483

Hospital & facility affiliations

  • St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084
  • Adventist Health Lodi Memorial Hospital, Lodi, CA, CCN 050336

Merit-based Incentive Payment System (MIPS)

Final score
74.25 of 100Reported as group
Quality
51.19
Promoting interoperability
94
Improvement activities
40
Cost
61.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G87118CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacramento Ear Nose & Throat Surgical & Medical Group Inc Otolaryngology CurrentSince Jan 1, 2014 Accepting new patients
Excell E.N.T. Medical Group, Inc. Otolaryngology Past Accepting new patients
West Suburban Head and Neck Specialists,S.C. Otolaryngology Past Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

801 S Ham Ln
Ste O
Lodi, CA 95242
Phone (209) 365-0526

1111 Exposition Blvd
Ste 700
Sacramento, CA 95815
Phone (916) 736-3399

1111 Exposition Blvd
Bldg 700
Sacramento, CA 95815
Phone (916) 736-3399

10200 Trinity Pkwy
Ste 201
Stockton, CA 95219
Phone (209) 952-0483

3132 W March Ln
Ste 2
Stockton, CA 95219
Phone (209) 478-1030

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rdong220387@hisp.ehr.sutterhealth.org

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.

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1194764472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 EXPOSITION BLVD",
            "address_2": "BLDG 700",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154314",
            "telephone_number": "916-736-3408",
            "fax_number": "916-233-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 TRINITY PKWY STE 201",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952197288",
            "telephone_number": "209-952-0483",
            "fax_number": "209-478-5785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 S Ham Ln Ste O",
            "address_purpose": "LOCATION",
            "city": "Lodi",
            "state": "CA",
            "postal_code": "952427502",
            "country_code": "US",
            "telephone_number": "209-952-0483",
            "fax_number": "209-478-5785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONG",
        "first_name": "RONALD",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G87118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.