Individual provider Active NPI

Andrew Hong, MD

  • Occupational Medicine Physician
  • New Haven, CT
National Provider Identifier
1407475775
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
76830 Issued in CT
Practice address
175 Sherman Ave FL 5
New Haven, CT 06511-4357
Phone
(203) 789-3721
NPI assigned
Apr 15, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0101272649 VA
Student in an Organized Health Care Education/Training Program 390200000X
Occupational Medicine Physician 2083X0100X 76830 CT Primary

Addresses

Primary practice location

175 Sherman Ave FL 5
New Haven, CT 06511-4357

Mailing address

175 Sherman Ave FL 5
New Haven, CT 06511-4357
Phone (203) 789-3721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20220125000918 VA Practitioner - General Practice 2264856111 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76830CTMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC General Practice CurrentSince Dec 1, 2021 Accepting new patients
Northeast Medical Group, Inc. PastSince Jun 16, 2024 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

1806 Summit Ave
Richmond, VA 23230
Phone (213) 433-2823

Interoperability endpoints

  • Direct secure messaging: ahong577456@direct.ynhh.org

Organizations & group practices 2

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": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1407475775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 SHERMAN AVE FL 5",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114357",
            "telephone_number": "203-789-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 SHERMAN AVE FL 5",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114357",
            "telephone_number": "203-789-3721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONG",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-15",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101272649",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CT",
            "license": "76830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.