Mary Jennifer Yao Ong Phuong, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

01057246 Issued in IN

Practice address

5734 Coventry LN
Fort Wayne, IN 46804-7141

Phone

(260) 436-8775

Fax

(260) 432-9812

NPI assigned

May 16, 2006

Last updated

Nov 4, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN, WI, CA3 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 3

Specialty

Anesthesiology

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 29)

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• Associated Anesthesiologists of Fort Wayne PC

  dba Midwest Anesthesia Associates

  • Anesthesiology Physician
  • Fort Wayne, IN
  • NPI 1538159140
  Medicare reassignment NPD
• Vituity-Wisconsin Anesthesia SC

  • Anesthesiology Physician
  • Pleasant Prairie, WI
  • NPI 1821831975
  Medicare reassignment NPD
• Three Rivers Anesthesia, LLC

  • Anesthesiology Physician
  • Fort Wayne, IN
  • NPI 1760542468
  NPD (past) Authorized official
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510

  Anesthesiology

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667

  Anesthesiology

  NPD
• Vituity-Wisconsin Anesthesia SC

  • Anesthesiology Physician
  • Milwaukee, WI
  • NPI 1801620067
  NPD
• Northeast Indiana Anesthesiology, PC

  • Anesthesiology Physician
  • Columbia City, IN
  • NPI 1619917366
  NPD (past)
• Parkview Health System Inc

  dba Parkview Physicians Group

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952

  Anesthesiology

  NPD (past)
• Preferred Anesthesia Consultants, P.C.

  • Anesthesiology Physician
  • Fort Wayne, IN
  • NPI 1639176837
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pennock Hospital

  dba Corewell Health Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  dba Corewell Health Grand Rapids Hospital

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1346292604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 LAKE AVE",
            "address_2": "OPERATING ROOM - THIRD FLOOR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055100",
            "telephone_number": "260-426-5431",
            "fax_number": "260-460-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5734 COVENTRY LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047141",
            "telephone_number": "260-436-8775",
            "fax_number": "260-432-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUONG",
        "first_name": "MARY JENNIFER",
        "middle_name": "YAO ONG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01057246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200445020",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Arthur Phillips II
• Sheri Lynn Phillips, BSN
• Phoenix Associates Inc.
• Phoenix Social Work Center, Inc.
• Loi K Phuong, MD
• Physical Medicine Consultants LLC
• Physical Medicine Consultants LLC
• Physiotherapy Associates
• Physiotherapy Associates Inc (Physiotherapy Associates)
• Physiotherapy Associates Inc (Physiotherapy Associates)

• Anesthesiology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.