Dale S.N. Fong, O.D.

Key facts

NPI

1801949508

Entity type

Individual (NPI type 1)

Primary specialty

Optometrist 152W00000X

License

165D (HI)

Practice address

725 Kapiolani Blvd Ste C204
Honolulu, HI 96813-6023

Phone

(808) 593-8939

Fax

(808) 593-8307

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

No

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.

• Fong Eyecare Center, LLC Optometrist · Honolulu, HI · NPI 1902042757
  Medicare reassignment Care Compare group HI
• Fong Vision Center, Inc. Optometrist · Honolulu, HI · NPI 1730221953
  NPD (past) OPTOMETRIST

Medicare Care Compare profile

Specialty

Optometry

Education

Pacific University - College of Optometry, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fong Eyecare Center LLC (2 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 28, 2011.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296172800000",
    "number": "1801949508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 KAPIOLANI BLVD STE C204",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968136023",
            "telephone_number": "808-593-8939",
            "fax_number": "808-593-8307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 KAPIOLANI BLVD STE C204",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968136023",
            "telephone_number": "808-593-8939",
            "fax_number": "808-593-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "DALE",
        "middle_name": "S.N.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "165D",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24450701",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA-QUEST",
            "identifier": "0000026195",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "026195",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

• Fong Vision Center, Inc.
• Aaron Fong, MD
• Amelia Ann Fong, MD
• Andrew C. O. Fong, MD
• Brent W.L. Fong II
• Fiona Fong, LMHC
• Frederick Fong, M.D.
• Gregory K. Fong, D.D.S.
• Henry Hung Chong Fong, M.D.
• Jackson Z Fong, PHARM.D

All providers in Honolulu, HI · Optometrist in Hawaii