Individual provider Active NPI

Tom Tien Dang, DPM

  • Podiatrist
  • Commerce, GA
National Provider Identifier
1649474032
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD000824 Issued in GA
Practice address
679 Hospital Road
Commerce, GA 30529-1146
Phone
(706) 335-4884
Fax
(706) 336-8798
NPI assigned
Jun 12, 2007
Last updated
Sep 30, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD000824 GA Primary

Addresses

Primary practice location

679 Hospital Road
Commerce, GA 30529-1146

Mailing address

679 Hospital Road
Commerce, GA 30529-1146
Phone (706) 335-4884

Other identifiers 3

IdentifierTypeStateIssuer
000771427FMedicaidGA
000771427GMedicaidGA
300029612CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050914000068 GA Practitioner - Podiatry 6901839612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1105 E Main St
Royston, GA 30662-3803
Phone (762) 338-5152

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue102
Removal of skin lesions1-10
Removal of nail tissue1726
Removal or shaving of skin growth1121
Skin biopsy27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
824GAMDMarriage & Family Therapist
00824GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Footcare, Inc. Podiatrist CurrentSince Oct 1, 2018 Accepting new patients
Global Wound Care Podiatrist PastSince Jan 1, 1998 Accepting new patients
Primary Foot & Ankle Care Podiatrist Past Accepting new patients

Locations

1105 E Main St
Royston, GA 30662
Phone (762) 338-5152

Interoperability endpoints

  • Direct secure messaging: tom.dang@3283.securemail.prognocis.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1649474032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "679 HOSPITAL ROAD",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305291146",
            "telephone_number": "706-335-4884",
            "fax_number": "706-336-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679 HOSPITAL ROAD",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305291146",
            "telephone_number": "706-335-4884",
            "fax_number": "706-336-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANG",
        "first_name": "TOM",
        "middle_name": "TIEN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD000824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000771427F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000771427G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300029612C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce, GA

Sources for this page

Verify at the official NPI Registry.