NPIMap

Individual provider Active NPI

Timothy Fong, DO

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1740743517
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
317242 Issued in NY
Practice address
506 6TH St
Brooklyn, NY 11215-3609
Phone
(780) 718-3000
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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
Emergency Medicine Physician 207P00000X 317242 NY Primary

Addresses

Primary practice location

506 6TH St
Brooklyn, NY 11215-3609

Mailing address

506 6TH St
Brooklyn, NY 11215-3609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230414001777 NY Practitioner - Emergency Medicine 6406221993 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
317242NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Physician Services, PC CurrentSince Jan 10, 2023 Accepting new patients
Kings Physician Services, PC Emergency Medicine CurrentSince Jan 10, 2023 Accepting new patients
New York University Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
New York University CurrentSince Aug 1, 2023 Accepting new patients

Locations

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677

2649 Strang Blvd
Ste 304
Yorktown Heights, NY 10598
Phone (646) 745-6369

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: tfong558678@nyumc.direct-ci.com

Organizations & group practices 4

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 7

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1740743517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609",
            "telephone_number": "780-718-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "TIMOTHY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "317242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.