Individual provider Active NPI

Richard W Gong, MD

  • Diagnostic Radiology Physician
  • Buffalo, NY
National Provider Identifier
1366459760
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
256327 Issued in NY
Practice address
Elm and Carlton Streets
Buffalo, NY 14263-3808
Phone
(716) 845-2300
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 256327 NY Primary

Addresses

Primary practice location

Elm and Carlton Streets
Buffalo, NY 14263-3808

Mailing address

601 Elmwood Ave Box 648
Rochester, NY 14642-8648
Phone (585) 487-3308

Other practice location 1

601 Elmwood Ave
Rochester, NY 14642-3808
Phone (585) 487-3308

Other identifiers 1

IdentifierTypeStateIssuer
04924338MedicaidNY

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
I20180110003133 NY Practitioner - Diagnostic Radiology 6406026343 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rpci Oncology, PCGroup PAC ID 3870731029, 62 clinicians
Roswell Park Cancer InstituteGroup PAC ID 3577475110, 487 clinicians

Practice addresses (Care Compare)

199 Park Club LN
Suite 100
Williamsville, NY 14221-5269
Phone (716) 332-6834

Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-2300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
256327NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roswell Park Cancer Institute CurrentSince Jun 3, 2019 Accepting new patients
Saif Soniwala,M.D.,PC Current Accepting new patients
Rpci Oncology PC CurrentSince Mar 2, 2020 Accepting new patients
Roswell Park Cancer Institute CurrentSince Jun 3, 2019 Accepting new patients
St James Hospital CurrentSince Jun 2, 2018 Accepting new patients

Locations

Dept 8000
Buffalo, NY 14267

Elm and Carlton St
Buffalo, NY 14263

411 Canisteo St
Hornell, NY 14843
Phone (607) 324-8000

7309 Seneca Rd N
Ste 108
Hornell, NY 14843
Phone (607) 385-3790

7329 Seneca Rd N
North Hornell, NY 14843
Phone (607) 247-2200

199 Park Club Ln
Ste 200
Williamsville, NY 14221
Phone (716) 634-3340

199 Park Club Ln
Ste 100
Williamsville, NY 14221
Phone (716) 332-6834

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.

Hospital & facility affiliations 1

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1366459760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE BOX 648",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146428648",
            "telephone_number": "585-487-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON STREETS",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142633808",
            "telephone_number": "716-845-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Elmwood Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146423808",
            "country_code": "US",
            "telephone_number": "585-487-3308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONG",
        "first_name": "RICHARD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "256327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04924338",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.