DR. MANUEL LIM ONG JR. M.D.
NPI 1932158664
Emergency Medicine in Carthage, MS

Q: What is Manuel Ong's NPI number?

The NPI number for Manuel Ong is 1932158664. It was assigned to this individual provider in the NPPES registry on May 9, 2006.

Q: What is Manuel Ong's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Manuel Ong was last updated on June 25, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 May 09, 2006PECOS EnrolledAccepts Medicare Assignment

1071 E FRANKLIN ST, CARTHAGE, MS 39051(601) 267-4562(601) 267-4589 Get Directions Write a Review

NPPES record last updated: June 25, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Dr. Manuel Lim Ong Jr. M.d. NPPES

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

DR. MANUEL LIM ONG JR. M.D. (NPI 1932158664) is an individual emergency medicine provider in Carthage, Mississippi, licensed in Mississippi (15199) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Neshoba County General Hospital, and maintains a secondary practice location in Carthage.

NPPES Registry Identity

NPI1932158664

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameDR. MANUEL LIM ONG JR.Credential: M.D.

Location Address1071 E FRANKLIN STCarthage, MS 39051-3601

Mailing Address1071 E Franklin StCarthage, MS 39051-3601 · (601) 824-1491

Phone(601) 267-4562

Fax(601) 267-4589

Sole ProprietorNo

Medical School CMSOtherGraduated 1987

Enumeration DateMay 9, 2006

Last NPPES UpdateJune 25, 2020

NPPES CertifiedJune 25, 2020

✔ NPI 1932158664 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in MS · 15199

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Also ListedInternal MedicineTaxonomy 207R00000X · License 15199 (MS)

1071 E FRANKLIN ST, Carthage, MS 39051

Open in Google Maps ↗

Secondary Practice Location 1

Location 11100 Highway 16 ECarthage, MS 39051-4222 · Phone (601) 267-1470 · Fax (601) 267-1469

Other Identifiers 1

Medicaid00118343MS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Manuel Lim Ong Jr. M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759350739

PECOS Enrollment IDI20040928000411

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 Reassignments

Medicare enrollment records show Manuel Ong reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Madden Medical Clinic LLC

Same address

Clinic/Center

1071 E FRANKLIN ST
Carthage, MS 39051

Reassigned Medicare billing, Mississippi enrollment
4 clinicians in this Medicare group

NPI 1114099439 (601) 267-4562

Baptist Medical Center-Leake, Inc.

2.2 mi

Rural Health

1100 HWY 16 EAST
Carthage, MS 39051

Reassigned Medicare billing, Mississippi enrollment
35 clinicians in this Medicare group

NPI 1194861260 (601) 267-1470

Leake Emergency Group, LLC

2.2 mi

Emergency Medicine

1100 HIGHWAY 16 E
Carthage, MS 39051

Reassigned Medicare billing, Mississippi enrollment
50 clinicians in this Medicare group

NPI 1669028130 (601) 267-1100

Correct Care, Inc.

162 mi

Emergency Medicine

229 SAINT JOHN LN
Covington, LA 70433

Reassigned Medicare billing, Mississippi enrollment
116 clinicians in this Medicare group

NPI 1215987441 (985) 773-1847

Dlw Medical Group

163 mi

Internal Medicine

216 AQUARIUS DR STE 310
Homewood, AL 35209

Reassigned Medicare billing, Mississippi enrollment
2 clinicians in this Medicare group

NPI 1215829809 (205) 994-8266

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

Areas of Expertise CMS Part B claims 27

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

500 services138 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

446 services164 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

246 services122 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

223 services119 patients

Injection, ketorolac tromethamine, per 15 mg J1885

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

198 services21 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

147 services76 patients

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

114 services51 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

96 services50 patients

Testing for presence of drug, read by direct observation 80305

Testing for the presence of drugs involves collecting a sample, usually urine, which is then analyzed for specific substances. The process is monitored directly to ensure accuracy and integrity. This test helps to confirm if drugs are present in your system.

92 services20 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

88 services21 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

78 services74 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

68 services68 patients

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

67 services26 patients

Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose J7324

Orthovisc is a treatment involving injections of a substance called hyaluronan into your joints. Hyaluronan is a natural substance in your joint fluid that aids in movement and reduces pain. The Orthovisc injections help replenish this substance, relieving joint pain.

62 services12 patients

Manual urinalysis test with examination using microscope, non-automated 81000

A manual urinalysis test involves studying a urine sample under a microscope. This non-automated method helps identify any abnormal substances present. It's a useful tool for detecting potential health concerns early. The process is simple and non-invasive.

50 services29 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

43 services42 patients

Telephone medical discussion with physician, 5-10 minutes 99441

A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.

41 services32 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

40 services39 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

35 services31 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

27 services25 patients

Blood glucose (sugar) measurement using reagent strip 82948

Blood glucose measurement using a reagent strip is a simple process. A tiny blood sample, usually taken from your finger, is placed on a test strip. The strip is inserted into a device that reads the blood sugar level. It's a quick, easy way to monitor blood sugar levels.

25 services25 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

23 services12 patients

Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99304

An initial nursing facility visit is a daily check-up to monitor your health status. This service, lasting typically 25 minutes, involves a nurse assessing your overall wellbeing, discussing concerns, and updating your care plan as needed.

22 services21 patients

Nursing facility discharge day management, 30 minutes or less 99315

Nursing facility discharge day management involves organizing your transition from the nursing facility to your home or another facility. This service, taking 30 minutes or less, includes finalizing medical instructions, arranging follow-up care, and answering any questions.

21 services21 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

18 services14 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

16 services13 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

13 services13 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Neshoba County General Hospital

Acute Care Hospitals · Philadelphia, MS

4/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number250043

Location1001 Holland AvenuePhiladelphia, MS 39350 · Neshoba County

Emergency services

Mississippi Baptist Medical Center

Acute Care Hospitals · Jackson, MS

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number250102

Location1225 N State StJackson, MS 39202 · Hinds County

Emergency services Birthing friendly

S E Lackey Memorial Hospital

Critical Access Hospitals · Forest, MS

OwnershipVoluntary non-profit - Private

CMS Certification Number251300

Location330 N Broad StreetForest, MS 39074 · Scott County

Emergency services

Baptist Medical Center-Leake

Critical Access Hospitals · Carthage, MS

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number251315

Location1100 Highway 16 East/Po Box 909Carthage, MS 39051 · Leake County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39051 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

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

55%13,256 patients2/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

61%7,140 patients2/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

20%2,081 patients1/55-star benchmark: 99%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

4%2,081 patients1/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 21

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers48 claims140 services$6.19 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

5 suppliers16 claims26 services$1.16 avg. paid by Medicare

Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4314

DME-Orthotic Devices · category DF000N

3 suppliers20 claims21 services$19.76 avg. paid by Medicare

Urinary catheter anchoring device, leg strap, each A4334

DME-Orthotic Devices · category DF000N

2 suppliers18 claims18 services$4.48 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

5 suppliers36 claims70 services$7.85 avg. paid by Medicare

Adhesive remover, wipes, any type, each A4456

DME-Medical/Surgical Supplies · category DA000N

3 suppliers12 claims675 services$0.23 avg. paid by Medicare

Skin barrier, wipes or swabs, each A5120

DME-Orthotic Devices · category DF010N

3 suppliers17 claims775 services$0.22 avg. paid by Medicare

Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing A6196

DME-Medical/Surgical Supplies · category DA023N

1 supplier12 claims307 services$7.09 avg. paid by Medicare

Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6212

DME-Medical/Surgical Supplies · category DA023N

1 supplier18 claims360 services$9.36 avg. paid by Medicare

Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard A6446

DME-Medical/Surgical Supplies · category DA023N

1 supplier12 claims1,344 services$0.34 avg. paid by Medicare

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034

Other-Enteral and Parenteral · category OB006N

2 suppliers14 claims261 services$4.14 avg. paid by Medicare

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035

Other-Enteral and Parenteral · category OB006N

1 supplier17 claims476 services$7.59 avg. paid by Medicare

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152

Other-Enteral and Parenteral · category OB006N

3 suppliers18 claims7,627 services$0.38 avg. paid by Medicare

Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4154

Other-Enteral and Parenteral · category OB006N

1 supplier12 claims6,678 services$0.82 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

3 suppliers22 claims22 services$61.23 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

5 suppliers57 claims57 services$20.17 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers28 claims28 services$6.72 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

7 suppliers110 claims115 services$110.42 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

3 suppliers13 claims3,319 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

2 suppliers15 claims1,290 services$0.09 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

6 suppliers27 claims27 services$25.16 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

MADDEN MEDICAL CLINIC LLC

Clinic/Center

1071 E FRANKLIN ST
CARTHAGE, MS 39051

Leake County (601) 267-4562

DAVID LAWRENCE MOODY MD

Family Medicine

1071 E FRANKLIN ST
CARTHAGE, MS 39051

Leake County (601) 267-4562

JANET KELLY

Nurse Practitioner (Family)

1071 E FRANKLIN ST
CARTHAGE, MS 39051

Leake County (601) 267-4562

VYTALIZE HEALTH

Family Medicine

1071 E FRANKLIN ST
CARTHAGE, MS 39051

Leake County (601) 267-4562

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Manuel Ong's NPI number?

The NPI number for Manuel Ong is 1932158664. It was assigned to this individual provider in the NPPES registry on May 9, 2006.

Where is Manuel Ong located?

Manuel Ong practices at 1071 E Franklin St, Carthage, MS 39051. The listed phone number is (601) 267-4562.

What is Manuel Ong's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Manuel Ong enrolled in Medicare?

Yes. Manuel Ong is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Manuel Ong's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Manuel Ong reassigns Medicare benefits to 5 organizations: Madden Medical Clinic LLC (Carthage, MS), Baptist Medical Center-Leake, Inc. (Carthage, MS), Leake Emergency Group, LLC (Carthage, MS), Correct Care, Inc. (Covington, LA) and Dlw Medical Group (Homewood, AL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Manuel Ong's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Manuel Ong accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 5 other insurers list Manuel Ong as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Manuel Ong affiliated with any hospitals?

According to CMS data, Manuel Ong is affiliated with Neshoba County General Hospital, Mississippi Baptist Medical Center, S E Lackey Memorial Hospital and Baptist Medical Center-Leake.

When was this NPI record last updated?

The NPPES record for Manuel Ong was last updated on June 25, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.