Individual provider Active NPI

Douglas Dung DO, M.D, M.P.H

  • Internal Medicine Physician
  • Hilo, HI
National Provider Identifier
1265732622
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD16142 Issued in HI
Practice address
1190 Waianuenue Ave
Hilo, HI 96720-2089
Phone
(925) 487-8947
NPI assigned
Nov 1, 2010
Last updated
Sep 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A114741 CA
Internal Medicine Physician 207R00000X MD16142 HI Primary

Addresses

Primary practice location

1190 Waianuenue Ave
Hilo, HI 96720-2089

Mailing address

1190 Waianuenue Ave
Hilo, HI 96720-2089
Phone (925) 487-8947

Other names 1

  • Dung Thuc DO Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, CA2 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
I20110823000349 HI Practitioner - Internal Medicine 0244400679 Reassigns benefits to 2 organizations
I20221109002855 CA Practitioner - Internal Medicine 0244400679 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A114741CAMDInternal Medicine Physician
MD16142HIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jul 10, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 10, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Quantum Healthcare Medical Associates Inc. Internal Medicine CurrentSince Aug 1, 2011 Accepting new patients
Hawaii Post-Acute Medical Services 1 Inc CurrentSince Aug 1, 2018 Accepting new patients
Quantum Bay Area Hospitalist Medical Group Inc Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

2500 Grant Rd
Mountain View, CA 94040
Phone (650) 903-9500

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1265732622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202089",
            "telephone_number": "925-487-8947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 WAIANUENUE AVE",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202089",
            "telephone_number": "925-487-8947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "DOUGLAS",
        "middle_name": "DUNG",
        "name_prefix": "Dr.",
        "credential": "M.D, M.P.H",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-01",
        "last_updated": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A114741",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD16142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DUNG",
            "last_name": "DO",
            "middle_name": "THUC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hilo, HI

Sources for this page

Verify at the official NPI Registry.