Individual provider Active NPI

Penn Tong, M.D

  • Diagnostic Radiology Physician
  • Gladwyne, PA
National Provider Identifier
1528403334
Registry record updated May 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MT203612 Issued in PA
Practice address
1310 N Avignon Dr
Gladwyne, PA 19035-1043
Phone
(484) 343-5062
NPI assigned
May 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2013

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 MT203612 PA Primary

Addresses

Primary practice location

1310 N Avignon Dr
Gladwyne, PA 19035-1043

Mailing address

1310 N Avignon Dr
Gladwyne, PA 19035-1043
Phone (484) 343-5062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190708000335 PA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 4486894359 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suburban Medical Group LLCGroup PAC ID 6204145642, 29 clinicians

Practice addresses (Care Compare)

2701 Dekalb Pike
2ND
East Norriton, PA 19401-1820
Phone (610) 275-1028

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT203612PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grandview Radiology Associates Diagnostic Radiology CurrentSince Aug 1, 2019 Accepting new patients
Bucks Mont Imaging Associates Inc.. Diagnostic Radiology Current Accepting new patients
Suburban Medical Group LLC CurrentSince Nov 1, 2022 Accepting new patients

Locations

2701 DeKalb Pike
Fl 2
East Norriton, PA 19401
Phone (610) 275-1028

5800 Ridge Ave
Philadelphia, PA 19128
Phone (215) 487-4334

700 Lawn Ave
Sellersville, PA 18960
Phone (215) 453-4000

711 Lawn Ave
Ste 2
Sellersville, PA 18960
Phone (215) 257-1050

Organizations & group practices 3

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 2

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": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1528403334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 N AVIGNON DR",
            "city": "GLADWYNE",
            "state": "PA",
            "postal_code": "190351043",
            "telephone_number": "484-343-5062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 N AVIGNON DR",
            "city": "GLADWYNE",
            "state": "PA",
            "postal_code": "190351043",
            "telephone_number": "484-343-5062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONG",
        "first_name": "PENN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-07",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MT203612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladwyne, PA

Sources for this page

Verify at the official NPI Registry.