Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Si M Bong

Individual provider Physician Assistant · NPI 1366077968

Si M Bong is a Physician Assistant in Flushing, New York. Qualified in 2019, 7 years ago. Licensed in New York.

Years since qualifying
7
Licensed in
NY
In the registry since
2020
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Practice location Address checks out

3916 Prince St Ste 251
Flushing, NY 11354-5367
Phone: (718) 886-3877
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 024591 (NY)

Record details

NPI number1366077968
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 4, 2020
Last updated in NPPESMarch 4, 2020
Certification dateMarch 4, 2020
Mailing address13811 63rd Ave, Flushing, NY 11367-1105

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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