Individual provider Active NPI

Johan Hong, MD

  • Internal Medicine Physician
  • San Jose, CA
National Provider Identifier
1245867019
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD19485 Issued in RI
Practice address
751 S Bascom Ave
San Jose, CA 95128-2604
Phone
(408) 885-5000
NPI assigned
Mar 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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 MD19485 RI Primary

Addresses

Primary practice location

751 S Bascom Ave
San Jose, CA 95128-2604

Mailing address

593 Eddy St
Providence, RI 02903-4923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, PA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20231019002137 RI Practitioner - Internal Medicine 7911353446 Reassigns benefits to 2 organizations
I20250801002588 PA Practitioner - Internal Medicine 7911353446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 Walnut St FL
16 Internal Med Spruce
Philadelphia, PA 19107-5176
Phone (215) 829-0101

Hospital & facility affiliations

  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health Internal Medicine Current Accepting new patients
Rhode Island Hospital CurrentSince Jan 1, 2024 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Mar 1, 2025 Accepting new patients
Rhode Island Hospital CurrentSince Jan 1, 2024 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Aug 25, 2025 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Mar 1, 2025 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince Aug 25, 2025 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Internal Medicine Past Accepting new patients

Locations

800 Walnut St
Fl 16
Philadelphia, PA 19107
Phone (215) 829-0101

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

245 Chapman St
Ste 300
Providence, RI 02905
Phone (401) 444-4741

110 Elm St
Providence, RI 02903
Phone (401) 443-4992

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

593 Eddy St
Providence, RI 02903

375 Wampanoag Trl
Riverside, RI 02915
Phone (401) 649-4010

Organizations & group practices 8

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": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1245867019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONG",
        "first_name": "JOHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD19485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.