NPIMap

Individual provider Active NPI

Brian Woongki Hong, M.D.

  • Surgery Physician
  • New London, WI
National Provider Identifier
1336431071
Registry record updated May 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
65808 Issued in WI
Practice address
1405 Mill St
New London, WI 54961-2155
Phone
(920) 531-2400
Fax
(920) 531-2450
NPI assigned
May 13, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X PENDING IL
Surgery Physician 208600000X 65808 WI Primary

Addresses

Primary practice location

1405 Mill St
New London, WI 54961-2155

Mailing address

100 Theda Clark Medical PLZ
Ste 400
Neenah, WI 54956-2763
Phone (920) 725-4527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20160822001482 WI Practitioner - General Surgery 5092010637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Wisconsin School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Associates of Neenah, S.C. 29 clinicians

Practice addresses (Care Compare)

100 Theda Clark Medical PLZ
Suite 400
Neenah, WI 54956-2763
Phone (920) 725-4527

130 2ND St
Neenah, WI 54956-2883
Phone (920) 729-3100

1405 Mill St
New London, WI 54961-2155
Phone (920) 531-2099

800 Riverside Dr
Waupaca, WI 54981-1943
Phone (920) 725-4527

Hospital & facility affiliations

  • Thedacare Medical Center - New London Hospital, New London, WI, CCN 521326
  • Thedacare Medical Center-Waupaca Hospital, Waupaca, WI, CCN 521334
  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy47
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux27
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PENDINGILMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Associates of Neenah, S.C. Surgery CurrentSince May 1, 2020 Accepting new patients

Locations

100 Theda Clark Medical Plz
Neenah, WI 54956
Phone (920) 722-7747

100 Theda Clark Medical Plz
Ste 400
Neenah, WI 54956
Phone (414) 725-4527

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

902 Riverside Dr
Ste 201
Waupaca, WI 54981
Phone (715) 256-3000

Interoperability endpoints

  • Direct secure messaging: bhong173605@direct.thedacare.org

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 9

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": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588464000000",
    "number": "1336431071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 THEDA CLARK MEDICAL PLZ",
            "address_2": "STE 400",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562763",
            "telephone_number": "920-725-4527",
            "fax_number": "920-729-2378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 MILL ST",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549612155",
            "telephone_number": "920-531-2400",
            "fax_number": "920-531-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONG",
        "first_name": "BRIAN",
        "middle_name": "WOONGKI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-13",
        "last_updated": "2020-05-03",
        "certification_date": "2020-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "65808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, WI

Sources for this page

Verify at the official NPI Registry.