Individual provider Active NPI

Andy Hoang, MD

  • Diagnostic Radiology Physician
  • San Luis Obispo, CA
National Provider Identifier
1235658485
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A177364 Issued in CA
Practice address
1100 Monterey St Ste 210
San Luis Obispo, CA 93401-3102
Phone
(805) 542-9700
NPI assigned
Sep 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 316090 NY
Internal Medicine Physician 207R00000X 271830 MA
Diagnostic Radiology Physician 2085R0202X A177364 CA Primary

Addresses

Primary practice location

1100 Monterey St Ste 210
San Luis Obispo, CA 93401-3102

Mailing address

1100 Monterey St Ste 210
San Luis Obispo, CA 93401-3102
Phone (805) 542-9700

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
I20220720002096 CA Practitioner - Diagnostic Radiology 2769758499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Luis Imaging Medical Group IncGroup PAC ID 2860618766, 4 clinicians

Practice addresses (Care Compare)

1100 Monterey St
Suite 210
San Luis Obispo, CA 93401-3102
Phone (805) 542-9700

Hospital & facility affiliations

  • French Hospital Medical Center Hospital, San Luis Obispo, CA, CCN 050232
  • Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107
  • Adventist Health Sierra Vista Hospital, San Luis Obispo, CA, CCN 050506

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A177364CAMDDiagnostic Radiology Physician
316090NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Luis Imaging Medical Group, Inc Diagnostic Radiology CurrentSince Jun 5, 2024 Accepting new patients

Locations

1100 Monterey St
#210
Sn Luis Obisp, CA 93401
Phone (805) 542-9700

1100 Monterey St
#200
Sn Luis Obisp, CA 93401
Phone (805) 542-9700

1911 Johnson Ave
Sn Luis Obisp, CA 93401
Phone (805) 542-6633

Organizations & group practices 1

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 3

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": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1235658485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MONTEREY ST STE 210",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013102",
            "telephone_number": "805-542-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MONTEREY ST STE 210",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013102",
            "telephone_number": "805-542-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOANG",
        "first_name": "ANDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-19",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "316090",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "271830",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A177364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.