Individual provider Active NPI

Duong M Duong, MD

  • Internal Medicine Physician
  • Lakewood, WA
National Provider Identifier
1831154293
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00017755 Issued in WA
Practice address
4901 108TH St SW
Lakewood, WA 98499-3724
Phone
(206) 682-2101
Fax
(206) 682-2089
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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 MD00017755 WA Primary

Addresses

Primary practice location

4901 108TH St SW
Lakewood, WA 98499-3724

Mailing address

PO Box 98886
Lakewood, WA 98496-8886
Phone (253) 589-6484

Other identifiers 1

IdentifierTypeStateIssuer
2099097MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20110302000594 WA Practitioner - Internal Medicine 4688855265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John H Addison MD PSGroup PAC ID 9335032887, 6 clinicians

Practice addresses (Care Compare)

9725 SE 36TH St
214 Northwest Geriatrics
Mercer Island, WA 98040-3840
Phone (206) 275-3588

Hospital & facility affiliations

  • Evergreen Health Hospice Care Hospice, Kirkland, WA, CCN 501523
  • Kline Galland Hospice Services Hospice, Seattle, WA, CCN 501540
  • Briarwood at Timber Ridge Nursing home, Issaquah, WA, CCN 505518

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00017755WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duong Minh Duong,MD,PS CurrentSince Jan 4, 2011 Accepting new patients
John H. Addison MD PS CurrentSince Dec 1, 2021 Accepting new patients
Dong Nai Pharmacy Past Accepting new patients

Locations

9725 SE 36th St
Ste 214
Mercer Island, WA 98040
Phone (206) 275-3588

9725 SE 36th St
Ste 410
Mercer Island, WA 98040
Phone (206) 275-3588

620 S Jackson St
Seattle, WA 98104
Phone (206) 624-4238

4901 108th St SW
Tacoma, WA 98499
Phone (253) 584-3577

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1831154293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98886",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984968886",
            "telephone_number": "253-589-6484",
            "fax_number": "253-984-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 108TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993724",
            "telephone_number": "206-682-2101",
            "fax_number": "206-682-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUONG",
        "first_name": "DUONG",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00017755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2099097",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.