Individual provider Active NPI

Charles Gregory Rong, MD

  • Student in an Organized Health Care Education/Training Program
  • Bay Shore, NY
National Provider Identifier
1629718291
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
37 Montgomery Ave
Bay Shore, NY 11706-8004
Phone
(631) 894-5334
NPI assigned
Mar 31, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

37 Montgomery Ave
Bay Shore, NY 11706-8004

Mailing address

37 Montgomery Ave
Bay Shore, NY 11706-8004
Phone (631) 894-5334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20251015000100 NY Practitioner - Emergency Medicine 5092202838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Healthy Way
Oceanside, NY 11572-1551

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Nassau Physician Group PC CurrentSince Jul 1, 2025 Accepting new patients

Locations

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

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 1

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": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1629718291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 MONTGOMERY AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068004",
            "telephone_number": "631-894-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 MONTGOMERY AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068004",
            "telephone_number": "631-894-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONG",
        "first_name": "CHARLES",
        "middle_name": "GREGORY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.