Individual provider Active NPI

Jennifer Fong

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1205331634
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
305045 Issued in NY
Practice address
622 W 168TH St PH 5-133
New York, NY 10032-3720
Phone
(212) 305-3226
NPI assigned
Mar 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 305045 NY Primary

Addresses

Primary practice location

622 W 168TH St PH 5-133
New York, NY 10032-3720

Mailing address

6921 173Rd St
Fresh Meadows, NY 11365-3432
Phone (917) 547-7051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220721002705 NY Practitioner - Anesthesiology 2668710211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

27005 75TH Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Jun 7, 2022 Accepting new patients
North Shore - Lij Anesthesiology, PC Anesthesiology CurrentSince Jan 1, 2023 Accepting new patients

Locations

7 Southwoods Blvd
Ste 4
Albany, NY 12211

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

27005 76th Ave
North New Hyde Pk, NY 11040

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 2

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 1

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": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1205331634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6921 173RD ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653432",
            "telephone_number": "917-547-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST PH 5-133",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "305045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.