NPIMap

Individual provider Active NPI

Andy Hong, MD

  • Nephrology Physician
  • Lynwood, CA
National Provider Identifier
1508861667
Registry record updated Dec 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A76731 Issued in CA
Practice address
3625 Martin Luther King Jr Blvd
Suite #5
Lynwood, CA 90262-3509
Phone
(310) 763-7504
Fax
(310) 763-7573
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A76731 CA Primary

Addresses

Primary practice location

3625 Martin Luther King Jr Blvd
Suite #5
Lynwood, CA 90262-3509

Mailing address

3625 Martin Luther King Jr Blvd
Suite #5
Lynwood, CA 90262-3509
Phone (310) 763-7504

Other identifiers 1

IdentifierTypeStateIssuer
00A767310MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050531000702 CA Practitioner - NephrologyPractitioner - Internal Medicine 1658313689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Northwestern University Feinberg Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3625 Martin Luther King Jr Blvd
Suite 5
Lynwood, CA 90262-3509
Phone (310) 763-7504

Hospital & facility affiliations

  • Fresenius Medical Care Norwalk East Dialysis facility, Santa Fe Springs, CA, CCN 552641
  • Centro de Cuidado Renal - Ela, LLC Dialysis facility, Los Angeles, CA, CCN 752578
  • DaVita Imperial Care Dialysis Center Dialysis facility, Lynwood, CA, CCN 052844
  • Saint Francis Medical Center Hospital, Lynwood, CA, CCN 050104
  • Los Angeles Community Hospital Hospital, Los Angeles, CA, CCN 050663
  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485
  • Coast Plaza Hospital Hospital, Norwalk, CA, CCN 050771
  • Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Andy Hong MD Inc Nephrology CurrentSince Apr 10, 2005 Accepting new patients

Locations

3625 Martin Luther King Jr Blvd
Ste 5
Lynwood, CA 90262
Phone (310) 763-7504

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291680000000",
    "number": "1508861667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE #5",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623509",
            "telephone_number": "310-763-7504",
            "fax_number": "310-763-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE #5",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623509",
            "telephone_number": "310-763-7504",
            "fax_number": "310-763-7573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONG",
        "first_name": "ANDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2010-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A76731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A767310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.