THEODORE T. FONG MD
NPI 1316025208
Internal Medicine - Critical Care Medicine in Stockton, CA

Q: What is Theodore Fong's NPI number?

The NPI number for Theodore Fong is 1316025208. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Q: What is Theodore Fong's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Q: When was this NPI record last updated?

The NPPES record for Theodore Fong was last updated on December 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 01, 2006PECOS Enrolled

7373 WEST LN, STOCKTON, CA 95210(209) 476-2000 Get Directions Write a Review

NPPES record last updated: December 2, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Theodore T. Fong Md NPPES

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

THEODORE T. FONG MD (NPI 1316025208) is an individual critical care medicine provider in Stockton, California, licensed in California (G77016) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316025208

Entity TypeIndividualMale

Primary Taxonomy207RC0200X

Provider Legal NameTHEODORE T. FONGCredential: MD

Location Address7373 WEST LNStockton, CA 95210-3377

Mailing Address1800 Harrison St Fl 7Oakland, CA 94612-3466 · (510) 625-6262

Phone(209) 476-2000

Sole ProprietorNo

Enumeration DateNovember 1, 2006

Last NPPES UpdateDecember 2, 2021

✔ NPI 1316025208 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RC0200X

License✔ Licensed in CA · G77016

Definition

An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

7373 WEST LN, Stockton, CA 95210

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Other Identifiers 1

Medicaid00G770160CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Theodore T. Fong Md 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.

Medicare Billing Reassignment

Medicare enrollment records show Theodore Fong reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc

Same address

Internal Medicine

7373 WEST LANE
Stockton, CA 95210

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1548343510 (209) 476-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95210 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$133.94 typical visit price

range $58.87 – $176.60

Typical copayment $33.48 (range $14.71 – $44.15)

Most-billed visit code 99204

Established Patient

$103.36 typical visit price

range $19.28 – $144.60

Typical copayment $25.84 (range $4.82 – $36.15)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JASDEEP KAUR GILL PHARMD

Pharmacist (Ambulatory Care)