Phong Thanh Dargon, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

A128212 Issued in CA

Practice address

15030 7TH St
Victorville, CA 92395-3811

Phone

(760) 951-0065

Fax

(760) 951-5382

NPI assigned

Jun 11, 2008

Last updated

Nov 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Vascular Surgery

Education

University of Massachusetts Medical School, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western Bariatric a Medical CorporationGroup PAC ID 3476607052, 12 clinicians

Western Vascular a Medical CorporationGroup PAC ID 4981106093, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Bernardine Medical Center Hospital, San Bernardino, CA, CCN 050129
• Redlands Community Hospital Hospital, Redlands, CA, CCN 050272

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: phongdargon@wdsmdinc.allscriptsdirect.net

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.

• Western Bariatric, a Medical Corporation

  • Surgery Physician
  • San Bernardino, CA
  • NPI 1184821373
  Medicare reassignment Care Compare group NPD
• Western Vascular a Medical Corporation

  • Vascular Surgery Physician
  • San Bernardino, CA
  • NPI 1497486245
  Medicare reassignment Care Compare group NPD

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

• Dignity Health

  dba St. Bernardine Medical Center

  • General Acute Care Hospital
  • San Bernardino, CA
  • NPI 1689769911
  Care Compare affiliation
• Redlands Community Hospital

  • General Acute Care Hospital
  • Redlands, CA
  • NPI 1043354111
  Care Compare affiliation

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1679733927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15030 7TH ST",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953811",
            "telephone_number": "760-951-0065",
            "fax_number": "760-951-5382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15030 7TH ST",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953811",
            "telephone_number": "760-951-0065",
            "fax_number": "760-951-5382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARGON",
        "first_name": "PHONG",
        "middle_name": "THANH",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-11",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "236799",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A128212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlen Daniels
• Gloria Daniels
• Katherine A Daniels
• Melissa Daniels, PSYD
• Danny M Colton, MD, Inc.
• Melissa Christine Darnell, LMFT
• Nashwa Darwish Moustafa, PMHNP
• Krishna Kumar Das, M.D.
• Sourav Das, MD
• Sarah Noel Dauria

• Vascular Surgery Physician in Victorville, CA
• Providers in Victorville, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; 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.