Individual provider Active NPI

Timothy Allan Gong, M.D.

  • Cardiovascular Disease Physician
  • Dallas, TX
National Provider Identifier
1992023188
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
R1373 Issued in TX
Practice address
3410 Worth St Ste 250
Dallas, TX 75246-2073
Phone
(214) 820-6856
NPI assigned
May 12, 2010
Last updated
Mar 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X R1373 TX Primary

Addresses

Primary practice location

3410 Worth St Ste 250
Dallas, TX 75246-2073

Mailing address

3500 Gaston Ave
Dallas, TX 75246-2017
Phone (214) 820-2362

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tgong457163@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170829003832 TX Practitioner - Cardiovascular Disease (Cardiology) 6406158831 Reassigns benefits to 1 organization
Practice locations: Dallas, TX

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Saint Louis University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1901 N Macarthur Blvd
Irving, TX 75061-2220
Phone (972) 579-8485

3500 Gaston Ave
FL 1
Dallas, TX 75246-2017
Phone (972) 817-6100

4001 Worth St
Dallas, TX 75246-1608

611 N Hall St
400 Baylor Scott and White Cardiology Consult
Dallas, TX 75226-1337
Phone (469) 800-7400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Aug 7, 2017 Accepting new patients
Healthtexas Provider Network CurrentSince Aug 7, 2017 Accepting new patients
Healthtexas Provider Network Cardiovascular Disease Current Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

3410 Worth St
Ste 250
Dallas, TX 75246
Phone (214) 820-6856

3500 Gaston Ave
Dallas, TX 75246

3500 Gaston Ave
Fl 4
Dallas, TX 75246
Phone (214) 957-1067

3600 Gaston Ave
Ste 558
Dallas, TX 75246

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1992023188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462017",
            "telephone_number": "214-820-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 WORTH ST STE 250",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462073",
            "telephone_number": "214-820-6856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "TIMOTHY",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-12",
        "last_updated": "2022-03-31",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "R1373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgong457163@direct.sw.org",
            "affiliation": "N",
            "address_1": "3410 Worth St Ste 250",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752462073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.