Perry Pong, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

175624 Issued in NY

Practice address

268 Canal St
New York, NY 10013-3599

Phone

(212) 379-6998

Fax

(212) 379-6930

NPI assigned

Dec 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: ppong@1120.direct.myezyaccess.com
• Direct secure messaging: ppong787564@direct.ochin.org

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Charles B. Wang Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1144203498

  Corporate Officer, W-2 Managing Employee

  CMS ownership

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.

• Charles B. Wang Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • New York, NY
  • NPI 1417261298
  NPD (past)

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1962488254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WALKER ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134135",
            "telephone_number": "212-226-8866",
            "fax_number": "212-226-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 CANAL ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100133599",
            "telephone_number": "212-379-6998",
            "fax_number": "212-379-6930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONG",
        "first_name": "PERRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "175624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01629143",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manish Prakash Ponda, M.D.
• Amber Nicole Pondexter I
• Claire Gillian Poneman, LMSW
• John M Poneros, MD
• Jonathan D. Pong, DMD
• Paula Pongsuwan, PHARM D
• Pudit Pongvitayapanu
• Diego Andres Ponieman, MD
• Sanjana Ponnam
• Madhavi Ponnapalli, MD

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.