Individual provider Active NPI

Tae-Soon Q Hong, MD

  • Internal Medicine Physician
  • Cambria Heights, NY
National Provider Identifier
1790726347
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
119479 Issued in NY
Practice address
20620 Linden Blvd
Cambria Heights, NY 11411-1524
Phone
(718) 479-6600
Fax
(718) 217-3546
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 119479 NY Primary

Addresses

Primary practice location

20620 Linden Blvd
Cambria Heights, NY 11411-1524

Mailing address

1000 Zeckendorf Blvd
Garden City, NY 11530-2133
Phone (516) 542-6880

Other identifiers 1

IdentifierTypeStateIssuer
01724170MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
119479NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Long Island Medical Group, P.C. Internal Medicine Past Accepting new patients
Qlimg Rochdale Village OB/GYN Office Internal Medicine Past Accepting new patients
Anesthesia Patient Services, PLLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1790726347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ZECKENDORF BLVD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302133",
            "telephone_number": "516-542-6880",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20620 LINDEN BLVD",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114111524",
            "telephone_number": "718-479-6600",
            "fax_number": "718-217-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONG",
        "first_name": "TAE-SOON",
        "middle_name": "Q",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "119479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01724170",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambria Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.