Individual provider Active NPI

Olivia Tong

  • Neurology Physician
  • Sacramento, CA
National Provider Identifier
1205249968
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
295132 Issued in NY
Practice address
3160 Folsom Blvd Ste 2100
Sacramento, CA 95816
Phone
(916) 734-3588
NPI assigned
Jun 10, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME165965 FL
Neurology Physician 2084N0400X 295132 NY Primary

Addresses

Primary practice location

3160 Folsom Blvd Ste 2100
Sacramento, CA 95816

Mailing address

3160 Folsom Blvd Ste 2100
Sacramento, CA 95816-5266

Other practice location 1

11215 Metro Pkwy Ste 100
Fort Myers, FL 33966-1206
Phone (239) 208-2206

Other practice location 2

630 Eaton Ave
Hamilton, OH 45013-2767
Phone (513) 867-2000

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/
Direct Messaging Address otong907557@direct.ketteringhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MA, OH, SC4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20240229004584 FL Practitioner - Neurology 8224378138 Reassigns benefits to 3 organizations
I20240301000191 MA Practitioner - Neurology 8224378138
I20240319002030 OH Practitioner - Neurology 8224378138 Reassigns benefits to 1 organization
I20240430000877 SC Practitioner - Neurology 8224378138 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
295132NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Cheraw CurrentSince Apr 15, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Mar 1, 2024 Accepting new patients
Kettering Independent Medical Group Inc CurrentSince Feb 8, 2024 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc Neurology CurrentSince Apr 15, 2024 Accepting new patients
McLeod Health Clarendon CurrentSince Apr 15, 2024 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Nchmd, Inc CurrentSince Mar 13, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Mar 1, 2024 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Apr 15, 2024 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Apr 15, 2024 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Nchmd Inc Current Accepting new patients
Landmark Hospital of Southwest Florida, LLC CurrentSince Mar 13, 2024 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
McLeod Health Cheraw CurrentSince Apr 15, 2024 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Apr 15, 2024 Accepting new patients
McLeod Health Clarendon CurrentSince Apr 15, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

11215 Metro Pkwy
Ste 1
Fort Myers, FL 33966
Phone (239) 208-2206

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

11190 Health Park Blvd
Naples, FL 34110
Phone (239) 300-9721

630 Eaton Ave
Hamilton, OH 45013
Phone (513) 867-2000

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

301 E Jackson St
Dillon, SC 29536
Phone (843) 774-1166

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

3655 Mitchell St
Loris, SC 29569
Phone (843) 716-7000

10 E Hospital St
Manning, SC 29102
Phone (803) 433-3000

50 E Hospital St
Ste 2
Manning, SC 29102
Phone (803) 433-0797

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1205249968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 FOLSOM BLVD STE 2100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 FOLSOM BLVD STE 2100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95816",
            "telephone_number": "916-734-3588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11215 Metro Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339661206",
            "country_code": "US",
            "telephone_number": "239-208-2206",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "630 Eaton Ave",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "OH",
            "postal_code": "450132767",
            "country_code": "US",
            "telephone_number": "513-867-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TONG",
        "first_name": "OLIVIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME165965",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "295132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "630 Eaton Ave",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450132767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "otong907557@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "630 Eaton Ave",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450132767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.