Individual provider Active NPI

Paulette Ong, PA-C

  • Medical Physician Assistant
  • Davenport, IA
National Provider Identifier
1477528073
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
001272 Issued in IA
Practice address
1801 E 54TH St
Ste 100
Davenport, IA 52807-7209
Phone
(563) 323-1229
Fax
(563) 323-8240
NPI assigned
Feb 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001272 IA Primary
Medical Physician Assistant 363AM0700X 085001740 IL

Addresses

Primary practice location

1801 E 54TH St
Ste 100
Davenport, IA 52807-7209

Mailing address

1801 E 54TH St Ste 100
Davenport, IA 52807-7214
Phone (563) 323-1229

Other identifiers 2

IdentifierTypeStateIssuer
970024406OtherIARAILROAD MEDICARE
970024407OtherILRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address paulette.ong@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100714000104 IA Practitioner - Physician Assistant 4789770843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 6103829338, 262 clinicians

Practice addresses (Care Compare)

1801 E 54TH St
100 Mercyone Genesis
Davenport, IA 52807-7214
Phone (563) 421-0550

4700 E 56TH St
Davenport, IA 52807-2904

Hospital & facility affiliations

  • Genesis Medical Center-Davenport Hospital, Davenport, IA, CCN 160033
  • Mercyone Genesis Dewitt Medical Center Hospital, Dewitt, IA, CCN 161313
  • Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275
  • Mercyone Clinton Medical Center Hospital, Clinton, IA, CCN 160080
  • Genesis Medical Center, Aledo Hospital, Aledo, IL, CCN 141304

Merit-based Incentive Payment System (MIPS)

Final score
34.85 of 100Reported as group
Quality
21.4
Improvement activities
0
Cost
76.92

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001272IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System CurrentSince Oct 8, 2019 Accepting new patients
Genesis Health System CurrentSince Oct 8, 2019 Accepting new patients
Pulmonary Associates of QC PC Past Accepting new patients
Genesis Health System Past Accepting new patients

Locations

865 Lincoln Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-1000

1801 E 54th St
Ste 100
Davenport, IA 52807
Phone (563) 323-1229

4700 E 56th St
Ste 100
Davenport, IA 52807
Phone (563) 383-2667

1351 W Central Park Ave
Ste 340
Davenport, IA 52804
Phone (563) 421-1287

Organizations & group practices 4

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 5

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1477528073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 E 54TH ST STE 100",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528077214",
            "telephone_number": "563-323-1229",
            "fax_number": "563-323-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E 54TH ST",
            "address_2": "STE 100",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528077209",
            "telephone_number": "563-323-1229",
            "fax_number": "563-323-8240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONG",
        "first_name": "PAULETTE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "001272",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085001740",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970024406",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970024407",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "paulette.ong@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1801 E 54th St",
            "address_2": "Ste 100",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528077209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.