Individual provider Active NPI

John Tsung-Long Tseng, MD

  • Emergency Medicine Physician
  • Wilmington, NC
National Provider Identifier
1770588162
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
9901628 Issued in NC
Practice address
4402 Shipyard Blvd
Wilmington, NC 28403-6161
Phone
(910) 202-3363
Fax
(910) 332-1072
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 9901628 NC Primary

Addresses

Primary practice location

4402 Shipyard Blvd
Wilmington, NC 28403-6161

Mailing address

4402 Shipyard Blvd
Wilmington, NC 28403-6161
Phone (910) 202-3363

Other identifiers 7

IdentifierTypeStateIssuer
1235XOtherNCBCBS
B4559OtherNCMEDCOST
930084658OtherNCRAILROAD MEDICARE
01-28693OtherNCUNITED HEALTHCARE
195176MedicaidSC
891235XMedicaidNC
930082860OtherNCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20091228000453 NC Practitioner - Emergency Medicine 0446390314 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9901628NCMDEmergency Medicine Physician
00142NCMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ecep II PA Emergency Medicine CurrentSince Oct 30, 1999 Accepting new patients
Ecep II PA Emergency Medicine CurrentSince Oct 30, 1999 Accepting new patients

Locations

507 E Fremont St
Burgaw, NC 28425
Phone (910) 259-5451

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

3710 Shipyard Blvd
Wilmington, NC 28403
Phone (910) 202-3363

5301 Wrightsville Ave
Wilmington, NC 28403
Phone (910) 452-8100

151 Scotts Hill Medical Dr
Wilmington, NC 28411
Phone (910) 662-8440

4402 Shipyard Blvd
Wilmington, NC 28403
Phone (910) 202-3363

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1770588162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036161",
            "telephone_number": "910-202-3363",
            "fax_number": "910-332-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036161",
            "telephone_number": "910-202-3363",
            "fax_number": "910-332-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSENG",
        "first_name": "JOHN",
        "middle_name": "TSUNG-LONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "9901628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1235X",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "B4559",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930084658",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "01-28693",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195176",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891235X",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930082860",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.