NPIMap

Individual provider Active NPI

Paul H Gong, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Louisville, KY
National Provider Identifier
1487180964
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
59299 Issued in KY
Practice address
3999 Dutchmans LN Ste 5D
Louisville, KY 40207-4744
Phone
(502) 899-6782
Fax
(502) 540-7268
NPI assigned
May 3, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 59299 KY Primary

Addresses

Primary practice location

3999 Dutchmans LN Ste 5D
Louisville, KY 40207-4744

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240919002727 KY Practitioner - Neurology 4082155858 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Louisville School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

210 E Gray St
Suite 1003
Louisville, KY 40202-3906
Phone (502) 629-2602

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59299KYMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children'S Medical Group, LLC CurrentSince Sep 19, 2024 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Norton Children'S Medical Group, LLC Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Norton Children'S Medical Group, LLC CurrentSince Sep 19, 2024 Accepting new patients
Community Medical Associates, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Community Medical Associates, Inc. Past Accepting new patients

Locations

3999 Dutchmans Ln
Ste 5D
Louisville, KY 40207
Phone (502) 897-1891

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

210 E Gray St
Ste 1003
Louisville, KY 40202
Phone (502) 629-2602

Interoperability endpoints

  • Direct secure messaging: pgong103123@direct.nortonhealthcare.org

Organizations & group practices 7

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1487180964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3999 DUTCHMANS LN STE 5D",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074744",
            "telephone_number": "502-899-6782",
            "fax_number": "502-540-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "PAUL",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-03",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "KY",
            "license": "59299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.