Individual provider Active NPI

John Paul Tracy NG, M.D.

  • Radiation Oncology Physician
  • New York, NY
National Provider Identifier
1336140433
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
182321 Issued in NY
Practice address
408 Broadway
1St Floor
New York, NY 10013-3699
Phone
(212) 925-8882
Fax
(212) 925-8883
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 182321 NY Primary

Addresses

Primary practice location

408 Broadway
1St Floor
New York, NY 10013-3699

Mailing address

408 Broadway
1St Floor
New York, NY 10013-3699
Phone (212) 925-8882

Other identifiers 1

IdentifierTypeStateIssuer
01466595MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20041206001122 NY Practitioner - Radiation Oncology 7810953353 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brooklyn Radiation Oncology PC Radiation Oncology CurrentSince Dec 1, 2020 Accepting new patients
Radiation Oncology Medical Practice of St Vincents PC Radiation Oncology Past Accepting new patients
Advanced Imaging & Radiology of Lenox Hill Hospital PC Past Accepting new patients
Lenox Hill Medical Associates, PLLC Radiation Oncology Past Accepting new patients
Premier Physicians of New York PLLC Radiation Oncology PastSince Oct 1, 2012 Accepting new patients

Locations

2101 Avenue X
Brooklyn, NY 11235
Phone (718) 257-0200

8715 5th Ave
Brooklyn, NY 11209
Phone (718) 836-2200

2508 Ocean Ave
Brooklyn, NY 11229
Phone (718) 258-1800

15806 Northern Blvd
Flushing, NY 11358
Phone (718) 353-3688

61 E 77th St
New York, NY 10075
Phone (212) 772-2130

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

139 Centre St
Ste 620
New York, NY 10013
Phone (212) 288-8084

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406073600000",
    "number": "1336140433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 BROADWAY",
            "address_2": "1ST FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100133699",
            "telephone_number": "212-925-8882",
            "fax_number": "212-925-8883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 BROADWAY",
            "address_2": "1ST FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100133699",
            "telephone_number": "212-925-8882",
            "fax_number": "212-925-8883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NG",
        "first_name": "JOHN PAUL",
        "middle_name": "TRACY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2014-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "182321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01466595",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.