Jonathan Quang, MD
Individual provider Active NPI Emergency Medicine Physician · New London, CT
NPI 1982196127 · NPPES record last updated Aug 30, 2023
Key facts
- NPI
- 1982196127
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 75898 (CT)
- Practice address
- 365 Montauk Ave Ste 3.714
New London, CT 06320-4700 - Phone
- (860) 271-4326
- NPI assigned
- Jun 4, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- University of Massachusetts Medical School, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- LMW Healthcare Inc
Lawrence and Memorial Hospital Inc.
Practice addresses (Care Compare)
25 Wells St
Westerly, RI 02891-2922
Phone (401) 586-6000
365 Montauk Ave
New London, CT 06320-4700
Phone (860) 442-0711
Hospital & facility affiliations
- Lawrence & Memorial Hospital
- Westerly Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CT, RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230918000548 | CT | Practitioner - Emergency Medicine | 6800143900 | Reassigns benefits to 1 organization |
| I20230918000740 | RI | Practitioner - Emergency Medicine | 6800143900 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A173369 | CA | MD | Emergency Medicine Physician |
| 75898 | CT | MD | Emergency Medicine Physician |
| MT215031 | PA | MD | Emergency Medicine Physician |
| MD19481 | RI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LMW Healthcare Inc. | Emergency Medicine | Current |
Accepting new patients |
| Lawrence and Memorial Hospital, Inc. | Current |
Accepting new patients | |
| Pathology Consultants of New London, P.C. | Current | Accepting new patients | |
| Lawrence and Memorial Hospital, Inc. | Emergency Medicine | Current |
Accepting new patients |
| LMW Healthcare Inc. | Current |
Accepting new patients |
Locations
365 Montauk Ave
Ste 3714
New London, CT 06320
Phone (860) 271-4326
365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364
25 Wells St
Westerly, RI 02891
Phone (401) 348-3325
Interoperability endpoints
- jonathan.quang.1@14021.direct.athenahealth.com
- jquang628640@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | A173369 | CA | |
| Emergency Medicine Physician | 207P00000X | MD19481 | RI | |
| Emergency Medicine Physician | 207P00000X | 75898 | CT | Yes |
| Emergency Medicine Physician | 207P00000X | MT215031 | PA |
Addresses
Primary practice location
365 Montauk Ave Ste 3.714
New London, CT 06320-4700
Mailing address
365 Montauk Ave Ste 3.714
New London, CT 06320-4700
Phone (860) 271-4326
Other practice location 1
101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-8008
Other practice location 2
25 Wells St
Westerly, RI 02891-2934
Phone (401) 596-6000
Other practice location 3
2701 S Bristol St
Santa Ana, CA 92704-6201
Phone (714) 754-5454
Other providers in New London, CT
- Patricia M. Pugsley
- Stephen G Pulaski
- Charles Purcell
- Yilu Qin
- Quality Care Drug New London LLC
- Quest Diagnostics LLC
- Stephen F Quevedo
- Rachel Quinn-Brown
- Anthony Dennis Quinn
- Meagan Arline Quinn
All providers in New London, CT · Emergency Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.