Individual provider Active NPI

Nam N Duong, PAC

  • Medical Physician Assistant
  • Lemoyne, PA
National Provider Identifier
1730206111
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA052868 Issued in PA
Practice address
50 N 12TH St
Lemoyne, PA 17043-1440
Phone
(717) 234-2561
Fax
(717) 236-1121
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA052868 PA Primary

Addresses

Primary practice location

50 N 12TH St
Lemoyne, PA 17043-1440

Mailing address

50 N 12TH St
Lemoyne, PA 17043-1440
Phone (717) 234-2561

Other practice location 1

220 Wilson St Ste 104
Carlisle, PA 17013-3697
Phone (717) 234-2561

Other identifiers 1

IdentifierTypeStateIssuer
MA052868OtherPALICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070430000286 PA Practitioner - Physician Assistant 7315043809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1120 Cocoa Ave
Hershey, PA 17033-1712
Phone (717) 533-4141

50 N 12TH St
Pshmg Pulmonary Crit
Lemoyne, PA 17043-1440
Phone (717) 234-2561

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
65.84
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

220 Wilson St
Ste 104
Carlisle, PA 17013
Phone (717) 218-1832

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

50 N 12th St
Lemoyne, PA 17043
Phone (717) 243-2561

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730206111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N 12TH ST",
            "city": "LEMOYNE",
            "state": "PA",
            "postal_code": "170431440",
            "telephone_number": "717-234-2561",
            "fax_number": "717-236-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N 12TH ST",
            "city": "LEMOYNE",
            "state": "PA",
            "postal_code": "170431440",
            "telephone_number": "717-234-2561",
            "fax_number": "717-236-1121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Wilson St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Carlisle",
            "state": "PA",
            "postal_code": "170133697",
            "country_code": "US",
            "telephone_number": "717-234-2561",
            "fax_number": "717-236-1121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUONG",
        "first_name": "NAM",
        "middle_name": "N",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA052868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MA052868",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemoyne, PA

Sources for this page

Verify at the official NPI Registry.