Active NPI
John Wei Fong, PA
- Physician Assistant
- Portland, OR
National Provider Identifier
1013929959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA00295
- Practice address
- 2210 SE Steele Street
Portland, OR 97202 - Phone
- (503) 231-0014
- Fax
- (503) 233-1592
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA00295 | OR | Primary |
Addresses
Primary practice location
2210 SE Steele Street
Portland, OR 97202
Mailing address
14711 NE 20TH Cir
Vancouver, WA 98684-7826
Phone (360) 254-3888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA00295 | OR | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Medical Associates PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Lebanon, OR
- NPI 1336313923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013929959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14711 NE 20TH CIR",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986847826",
"telephone_number": "360-254-3888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2210 SE STEELE STREET",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97202",
"telephone_number": "503-231-0014",
"fax_number": "503-233-1592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONG",
"first_name": "JOHN",
"middle_name": "WEI",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OR",
"license": "PA00295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.