Individual provider Active NPI

Johnny Truong, D.O.

  • Family Medicine Physician
  • Sleepy Hollow, NY
National Provider Identifier
1730718834
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
320630 Issued in NY
Practice address
362 North Broadway
2ND Floor
Sleepy Hollow, NY 10591
Phone
(914) 269-1730
Fax
(914) 631-0797
NPI assigned
Apr 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 320630 NY Primary

Addresses

Primary practice location

362 North Broadway
2ND Floor
Sleepy Hollow, NY 10591

Mailing address

362 North Broadway
2ND Floor
Sleepy Hollow, NY 10591
Phone (914) 269-1730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20231017001199 NY Practitioner - Family Practice 0749635381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
320630NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Family Medicine CurrentSince Aug 21, 2023 Accepting new patients
North Shore - Lij Medical PC CurrentSince Aug 21, 2023 Accepting new patients

Locations

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

362 N Broadway
Ste 2
Sleepy Hollow, NY 10591
Phone (914) 631-2070

701 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 366-3140

Interoperability endpoints

  • Direct secure messaging: johnnytruong@nslijmedgr.allscriptsdirect.net

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": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1730718834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 NORTH BROADWAY",
            "address_2": "2ND FLOOR",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "10591",
            "telephone_number": "914-269-1730",
            "fax_number": "914-631-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 NORTH BROADWAY",
            "address_2": "2ND FLOOR",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "10591",
            "telephone_number": "914-269-1730",
            "fax_number": "914-631-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "JOHNNY",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2023-09-07",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "320630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sleepy Hollow, NY

Sources for this page

Verify at the official NPI Registry.