JUNG HO GONG
NPI 1003519737
Student in an Organized Health Care Education/Training Program in Providence, RI

Q: What is Jung Ho Gong's NPI number?

The NPI number for Jung Ho Gong is 1003519737. It was assigned to this individual provider in the NPPES registry on March 22, 2023.

Q: What is Jung Ho Gong's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jung Ho Gong was last updated on May 1, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 22, 2023PECOS Enrolled

593 EDDY ST, PROVIDENCE, RI 02903(401) 793-2695(401) 444-4165 Get Directions Write a Review

NPPES record last updated: May 1, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 1, 2024, Mar 22, 2023 (2 updates tracked since 2023).

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About Jung Ho Gong NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUNG HO GONG (NPI 1003519737) is an individual student in an organized health care education/training program in Providence, Rhode Island, licensed in Rhode Island (LP06245) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003519737

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJUNG HO GONG

Location Address593 EDDY STProvidence, RI 02903-4923

Mailing Address593 Eddy StProvidence, RI 02903-4923 · (401) 793-2695 · Fax (401) 444-4165

Phone(401) 793-2695

Fax(401) 444-4165

Sole ProprietorNo

Enumeration DateMarch 22, 2023

Last NPPES UpdateMay 1, 20242 updates tracked since enumeration

NPPES CertifiedMay 1, 2024

✔ NPI 1003519737 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in RI · LP06245

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

593 EDDY ST, Providence, RI 02903

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jung Ho Gong is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.