DR. HENRY LOREN FONG (M.D.) – Emergency Medical Services (Emergency Medicine) Physician, NPI 1306861158

DR. HENRY LOREN FONG (M.D.) is a healthcare provider. based in Petaluma, California. specializing in Emergency Medical Services (Emergency Medicine) Physician. They hold the professional credentials M.D.. They hold a License No. G69103 (CA). The NPI Number for DR. HENRY LOREN FONG (M.D.) is 1306861158

Main info

Male
Sole Proprietor
37 Years Of Experience
Accepts Medicare Assignment
Name
DR. HENRY LOREN FONG (M.D.)
NPI
1306861158
Phone
(707) 778-1111
Address
400 N MCDOWELL BLVD
Enumeration Date
13 July 2006
Last Update Date
14 April 2011

Doctor Profile

Medical School Name
RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Secondary Phone
7077781111
Graduation Year
1989 (37 years ago)
PAC ID
5991731549
Group Practice PAC ID
2365478914
Professional Enrollment ID
I20100304000739
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for DR. HENRY LOREN FONG (M.D.)

  • Petaluma Valley Hospital, 400, North McDowell Boulevard, Petaluma, Sonoma County, California, 94954, United States

    PETALUMA, CA 949542339

    Phone: (707) 778-1111

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-03-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100304000739IEmergency MedicineCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making158151$0
99284Emergency department visit with moderate level of medical decision making151136$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only6562$0
99283Emergency department visit with low level of medical decision making3535$0
99291Critical care, first 30-74 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 94954)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2365478914View full group profile

Reviews

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Frequently asked questions

How do I look up DR. HENRY LOREN FONG (M.D.) by NPI?
Use NPI 1306861158 when you need to reference DR. HENRY LOREN FONG (M.D.) in forms, claims, or directories.
Is DR. HENRY LOREN FONG (M.D.)'s NPI currently valid?
The extract we use shows DR. HENRY LOREN FONG (M.D.) as active.
What field does DR. HENRY LOREN FONG (M.D.) work in?
You can think of DR. HENRY LOREN FONG (M.D.) as practicing within Emergency Medical Services (Emergency Medicine) Physician. Clinical services aligned with this taxonomy classification.
Where is DR. HENRY LOREN FONG (M.D.)'s primary listing?
We display Petaluma, California because that is what the record indicates for DR. HENRY LOREN FONG (M.D.).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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