Quentin Phung, MD

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

234866-1 Issued in NY

Practice address

9 Old Plank Rd
Suite 100
Clifton Park, NY 12065-3107

Phone

(518) 371-0777

Fax

(518) 371-0366

NPI assigned

Jun 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: quentinphung@nypm.ssdirect.aprima.com

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.

• New York Pain Management PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Clifton Park, NY
  • NPI 1407884455

  NY, Pain Medicine

  Medicare reassignment NPD
• Abdul Naushad MD PC

  • Pain Medicine Physician
  • Poplar Bluff, MO
  • NPI 1306839196

  Pain Medicine

  NPD (past)
• Integrity Regional Pain Center LLC

  • Pain Medicine (Anesthesiology) Physician
  • Poplar Bluff, MO
  • NPI 1700489267
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Pain Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1306040936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 OLD PLANK RD",
            "address_2": "SUITE 100",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653107",
            "telephone_number": "518-371-0777",
            "fax_number": "518-371-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 OLD PLANK RD",
            "address_2": "SUITE 100",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653107",
            "telephone_number": "518-371-0777",
            "fax_number": "518-371-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUNG",
        "first_name": "QUENTIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "A234866",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NY",
            "license": "234866",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NY",
            "license": "234866-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSNENY PIN - SPECIALIST",
            "identifier": "000418627001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03056902",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSNENY PIN - ACUPUNTURIST",
            "identifier": "000418627005",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Perretta
• Danielle Petrone, PT
• Amy C Pfaffenbach, D.D.S.
• Geraldine G C Pfeiffer, PT
• Karen Phillips, MSPT
• Physical Therapy Associates of Schenectady
• Kelly Pickett
• Pinnacle Periodontics and Dental Implant Reconstruction, LLC
• Joseph Ponessa III, PT
• Jose Posada, MD

• All providers in Clifton Park, NY
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.

Verify at the official NPI Registry.