Individual provider Active NPI

Robert Lawrence Gong, MD

  • Family Medicine Physician
  • Cambria, CA
National Provider Identifier
1699834465
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G41145 Issued in CA
Practice address
2150 Main St Ste 3
Cambria, CA 93428-3022
Phone
(805) 927-8671
NPI assigned
Dec 8, 2006
Last updated
Jun 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G41145 CA Primary

Addresses

Primary practice location

2150 Main St Ste 3
Cambria, CA 93428-3022

Mailing address

PO Box 1238
Cambria, CA 93428-1238
Phone (805) 305-3367

Other identifiers 1

IdentifierTypeStateIssuer
00G411450MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drgong@earthlink.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090109000273 CA Practitioner - Family Practice 5991868499 Practice locations: Cambria, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G41145CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richard David Griffith MD, Inc. PastSince Jan 24, 2023 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25380/brand/1/csg/1/fhir/r4

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, 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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1699834465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1238",
            "city": "CAMBRIA",
            "state": "CA",
            "postal_code": "934281238",
            "telephone_number": "805-305-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 MAIN ST STE 3",
            "city": "CAMBRIA",
            "state": "CA",
            "postal_code": "934283022",
            "telephone_number": "805-927-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "ROBERT",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G41145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G411450",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drgong@earthlink.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2996 Somerset Way",
            "city": "Cambria",
            "state": "CA",
            "country_code": "US",
            "postal_code": "934283022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cambria, CA

Sources for this page

Verify at the official NPI Registry.