Individual provider Active NPI

Sheena Xinna Kong, MD

  • Internal Medicine Physician
  • San Francisco, CA
National Provider Identifier
1790862993
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A75253 Issued in CA
Practice address
1199 Bush Street
Suite 400
San Francisco, CA 94109
Phone
(415) 673-7600
Fax
(415) 673-8065
NPI assigned
Nov 1, 2006
Last updated
Apr 30, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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 A75253 CA Primary

Addresses

Primary practice location

1199 Bush Street
Suite 400
San Francisco, CA 94109

Mailing address

1199 Bush Street
Suite 400
San Francisco, CA 94109
Phone (415) 673-7600

Other identifiers 2

IdentifierTypeStateIssuer
110243772OtherMEDICARE RR
00A752530MedicaidCA

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
A75253CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1790862993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1199 BUSH STREET",
            "address_2": "SUITE 400",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94109",
            "telephone_number": "415-673-7600",
            "fax_number": "415-673-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 BUSH STREET",
            "address_2": "SUITE 400",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94109",
            "telephone_number": "415-673-7600",
            "fax_number": "415-673-8065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "SHEENA",
        "middle_name": "XINNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A75253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "110243772",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A752530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.