Individual provider Active NPI

Tiong Gwan The, MBBS, DCH

  • Pediatric Critical Care Medicine Physician
  • New Brunswick, NJ
National Provider Identifier
1790819951
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
25MA07116300 Issued in NJ
Practice address
254 Easton Ave
St Peter's University Hospital
New Brunswick, NJ 08901
Phone
(732) 745-8600
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 25MA07116300 NJ Primary

Addresses

Primary practice location

254 Easton Ave
St Peter's University Hospital
New Brunswick, NJ 08901

Mailing address

254 Easton Ave
St Peter's University Hospital
New Brunswick, NJ 08901

Other identifiers 1

IdentifierTypeStateIssuer
8878404MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20041027000818 NJ Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 2860454345 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07116300NJMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ijkg Opco LLC Current Accepting new patients
Saint Peter's University Hospital CurrentSince Mar 1, 2002 Accepting new patients
Saint Peter's University Hospital CurrentSince Mar 1, 2002 Accepting new patients

Locations

254 Easton Ave
Ofc
New Brunswick, NJ 08901
Phone (732) 745-6674

254 Easton Ave
New Brunswick, NJ 08901
Phone (732) 565-5453

123 How Ln
New Brunswick, NJ 08901
Phone (732) 448-1000

Interoperability endpoints

  • Direct secure messaging: tiong.the@direct.bayonnemedicalcenter.md
  • FHIR API: https://api.platform.athenahealth.com/8568/brand/1/csg/1/fhir/r4

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1790819951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 EASTON AVE",
            "address_2": "ST PETER'S UNIVERSITY HOSPITAL",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "08901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 EASTON AVE",
            "address_2": "ST PETER'S UNIVERSITY HOSPITAL",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "08901",
            "telephone_number": "732-745-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THE",
        "first_name": "TIONG",
        "middle_name": "GWAN",
        "name_prefix": "Dr.",
        "credential": "MBBS, DCH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NJ",
            "license": "25MA07116300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8878404",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.