Phuc Son Si Dong, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A12891 Issued in CA

Practice address

3980 Douglas Blvd Ste 110
Roseville, CA 95661-4263

Phone

(916) 293-4400

Fax

(916) 293-4401

NPI assigned

Jul 2, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Family Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy General Hospital Hospital, Sacramento, CA, CCN 050017

Merit-based Incentive Payment System (MIPS)

Final score

99.64 of 100Reported as apm

Quality

86.27

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1700803418
  Medicare reassignment Care Compare group NPD
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD
• Dignity Health

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1477671535
  NPD (past)
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Rancho Cordova, CA
  • NPI 1568489268
  NPD (past)

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

• Dignity Health

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1487694857
  Care Compare affiliation

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1598077869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 DOUGLAS BLVD STE 110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614263",
            "telephone_number": "916-293-4400",
            "fax_number": "916-293-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONG",
        "first_name": "PHUC",
        "middle_name": "SON SI",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-02",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A12891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Gwen Dominguez, SUDCC II
• Tiffany Dominguez, BS, SLPA
• Donald E. Clarke, D.D.S., Inc.
• Donald R. Peterson,II, M.D. Inc.
• Isabella S-M Donato
• Gail Lynn Donner
• Patrick Donohoe
• Jerold R. Dooley, MD
• John K Doolittle, MD
• Doris Shurden-Lopez, Inc

• Family Medicine Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.