Individual provider Active NPI

Lijuan Tong, MD

  • Specialist
  • San Antonio, TX
National Provider Identifier
1639175425
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
L9936 Issued in TX
Practice address
343 W Houston St Ste 306
San Antonio, TX 78205-2140
Phone
(210) 577-0673
Fax
(210) 247-9699
NPI assigned
Jun 27, 2005
Reactivated
Mar 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X L9936 TX Primary

Addresses

Primary practice location

343 W Houston St Ste 306
San Antonio, TX 78205-2140

Mailing address

PO Box 701543
San Antonio, TX 78270-1543
Phone (210) 497-1528

Other identifiers 1

IdentifierTypeStateIssuer
167943302MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040914001237 TX Practitioner - NephrologyPractitioner - Internal Medicine 0446227896

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L9936TXMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert G. Szewc, M.D., P.a. PastSince Oct 1, 2002 Accepting new patients
SNG - Barlite San Saba Dialysis Centers LP Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1639175425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 701543",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782701543",
            "telephone_number": "210-497-1528",
            "fax_number": "210-247-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 W HOUSTON ST STE 306",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782052140",
            "telephone_number": "210-577-0673",
            "fax_number": "210-247-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONG",
        "first_name": "LIJUAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2013-04-01",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "L9936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167943302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.