Individual provider Active NPI

Phong Nguyen-Ho, MD

  • Interventional Cardiology Physician
  • Buffalo, NY
National Provider Identifier
1356320204
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
M8215 Issued in TX
Practice address
3435 Bailey Ave
Buffalo, NY 14215-1145
Phone
(716) 835-2966
Fax
(716) 834-3901
NPI assigned
Jan 10, 2006
Last updated
Feb 14, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X M8215 TX
Interventional Cardiology Physician 207RI0011X M8215 TX Primary

Addresses

Primary practice location

3435 Bailey Ave
Buffalo, NY 14215-1145

Mailing address

3435 Bailey Ave
Buffalo, NY 14215-1145
Phone (716) 835-2966

Other identifiers 1

IdentifierTypeStateIssuer
8CA532OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002278NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Shiraz P Dhanani PA Cardiovascular Disease Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1356320204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 BAILEY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151145",
            "telephone_number": "716-835-2966",
            "fax_number": "716-834-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 BAILEY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151145",
            "telephone_number": "716-835-2966",
            "fax_number": "716-834-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN-HO",
        "first_name": "PHONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "M8215",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "M8215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8CA532",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.