NPIMap

Individual provider Active NPI

Robert Charles Gong, M.D.

  • Internal Medicine Physician
  • Henderson, NV
National Provider Identifier
1265409601
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7222 Issued in NV
Practice address
2789 Sunridge Heights Pkwy
Suite 100
Henderson, NV 89052-5052
Phone
(702) 614-0850
Fax
(702) 614-0798
NPI assigned
Mar 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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 7222 NV Primary

Addresses

Primary practice location

2789 Sunridge Heights Pkwy
Suite 100
Henderson, NV 89052-5052

Mailing address

2789 Sunridge Heights Pkwy
Suite 100
Henderson, NV 89052-5052
Phone (702) 614-0850

Other identifiers 1

IdentifierTypeStateIssuer
002019364MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100916000664 NV Practitioner - Internal Medicine 7315945045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Southern California Keck School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Siena Hills Primary CareGroup PAC ID 1254389216, 2 clinicians

Practice addresses (Care Compare)

2789 Sunridge Heights Pkwy
Suite 100
Henderson, NV 89052-5053
Phone (702) 614-0850

Hospital & facility affiliations

  • Las Vegas Home Health Care, Inc Home health agency, Las Vegas, NV, CCN 297168
  • St Agatha Home Health LLC Home health agency, Henderson, NV, CCN 297271
  • Enhabit Home Health (Pecos) Home health agency, Henderson, NV, CCN 297102
  • Care First Home Health Care Home health agency, Las Vegas, NV, CCN 297143
  • Saint Rose Dominican Hospitals - Siena Campus Hospital, Henderson, NV, CCN 290045

Merit-based Incentive Payment System (MIPS)

Final score
88.98 of 100Reported as apm
Quality
85.1
Promoting interoperability
88.1
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7222NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siena Hills Primary Care Internal Medicine CurrentSince Jan 20, 2000 Accepting new patients

Locations

2789 Sunridge Heights Pkwy
Ste 100
Henderson, NV 89052
Phone (702) 614-0850

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HIFHCA/Endpoint/HIFHCA
  • FHIR API: https://fhir4.healow.com/fhir/r4/HIFHCA

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 5

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1265409601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2789 SUNRIDGE HEIGHTS PKWY",
            "address_2": "SUITE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525052",
            "telephone_number": "702-614-0850",
            "fax_number": "702-614-0798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2789 SUNRIDGE HEIGHTS PKWY",
            "address_2": "SUITE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525052",
            "telephone_number": "702-614-0850",
            "fax_number": "702-614-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "7222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002019364",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.