NPIMap

Individual provider Active NPI

Angela Vong, M.D.

  • Pediatric Otolaryngology Physician
  • Woodbury, MN
National Provider Identifier
1780942243
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
63695 Issued in MN
Practice address
217 Radio Dr
Woodbury, MN 55125-5805
Phone
(651) 702-0750
Fax
(651) 645-6166
NPI assigned
May 2, 2012
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 82559-20 WI
Pediatric Otolaryngology Physician 207YP0228X 63695 MN Primary

Addresses

Primary practice location

217 Radio Dr
Woodbury, MN 55125-5805

Mailing address

215 Radio Dr Ste 202
Woodbury, MN 55125-5822
Phone (651) 702-0750

Other practice location 1

2651 Hillcrest Dr
Hudson, WI 54016-9914
Phone (651) 702-0750

Other practice location 2

11020 161st Street West
Lakeville, MN 55044
Phone (651) 702-0750

Other practice location 3

3460 Promenade Ave
Eagan, MN 55123-4404
Phone (651) 702-0750

Other practice location 4

3590 Arcade St
Vadnais Heights, MN 55127-7135
Phone (651) 702-0750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180831000182 MN Practitioner - Otolaryngology 9133421126 Reassigns benefits to 1 organization
I20250108001182 WI Practitioner - OtolaryngologyPractitioner - Pediatric Medicine 9133421126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Pediatric Medicine
Education
New York Medical College, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2651 Hillcrest Dr
Suite 302
Hudson, WI 54016-9919
Phone (651) 702-0750

3460 Promenade Ave E
Eagan, MN 55121
Phone (651) 702-0750

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
147814CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Ancillary Services, Inc CurrentSince Oct 1, 2018 Accepting new patients
Otolaryngology & Head & Neck Surgery, P.a. CurrentSince Oct 1, 2018 Accepting new patients

Locations

3460 Promenade Ave
Eagan, MN 55123

11020 161st St W
Lakeville, MN 55044

3590 Arcade St
Vadnais Heights, MN 55127

2080 Woodwinds Dr
Ste 240
Woodbury, MN 55125

215 Radio Dr
Ste 202
Woodbury, MN 55125
Phone (651) 867-9007

217 Radio Dr
Woodbury, MN 55125

2651 Hillcrest Dr
Ste 302
Hudson, WI 54016
Phone (651) 241-5290

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1780942243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 RADIO DR STE 202",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551255822",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 RADIO DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551255805",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2651 Hillcrest Dr",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "WI",
            "postal_code": "540169914",
            "country_code": "US",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11020 161st Street West",
            "address_purpose": "LOCATION",
            "city": "Lakeville",
            "state": "MN",
            "postal_code": "55044",
            "country_code": "US",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3460 Promenade Ave",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551234404",
            "country_code": "US",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3590 Arcade St",
            "address_purpose": "LOCATION",
            "city": "Vadnais Heights",
            "state": "MN",
            "postal_code": "551277135",
            "country_code": "US",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VONG",
        "first_name": "ANGELA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-02",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "WI",
            "license": "82559-20",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "MN",
            "license": "63695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.