Active NPI
Paulina Phomvongsa, MD
- Surgery Physician
- Dubuque, IA
National Provider Identifier
1265015358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD-57654
- Practice address
- 1000 Langworthy St
Dubuque, IA 52001-7313 - Phone
- (563) 584-3450
- Fax
- (563) 584-3171
- NPI assigned
- May 5, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD-57654 | IA | Primary |
Addresses
Primary practice location
1000 Langworthy St
Dubuque, IA 52001-7313
Mailing address
1000 Langworthy St
Dubuque, IA 52001-7313
Phone (563) 584-3450
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- pphomvongsa123258@direct.metrohealth.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788825600000",
"number": "1265015358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 LANGWORTHY ST",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520017313",
"telephone_number": "563-584-3450",
"fax_number": "563-584-3171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 LANGWORTHY ST",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520017313",
"telephone_number": "563-584-3450",
"fax_number": "563-584-3171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHOMVONGSA",
"first_name": "PAULINA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-05",
"last_updated": "2026-09-08",
"certification_date": "2026-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IA",
"license": "MD-57654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dubuque, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.