Individual provider Active NPI

Andrew David Rontal, M.D.

  • Vascular Neurology Physician
  • Portland, OR
National Provider Identifier
1063657328
Registry record updated Nov 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
MD159845 Issued in OR
Practice address
5050 NE Hoyt
Suite 315
Portland, OR 97213-2982
Phone
(503) 215-8580
NPI assigned
Dec 15, 2008
Last updated
Nov 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 39857 MT
Neurology Physician 2084N0400X 108649 AK
Neurology Physician 2084N0400X MD60478521 WA
Neurology Physician 2084N0400X A140879 CA
Neurology Physician 2084N0400X MD159845 OR
Vascular Neurology Physician 2084V0102X MD159845 OR Primary

Addresses

Primary practice location

5050 NE Hoyt
Suite 315
Portland, OR 97213-2982

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other identifiers 2

IdentifierTypeStateIssuer
P01355678OtherORRR MEDICARE (PH&S)-PMG
500653063MedicaidOR

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address arontal136909@oc.providencedirect.org
Direct Messaging Address arontal136909@oc.providencedirect.org
Direct Messaging Address arontal136909@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, MT, WA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20130710000362 OR Practitioner - Neurology 7911150065 Reassigns benefits to 10 organizations
I20170202001310 MT Practitioner - Neurology 7911150065 Reassigns benefits to 1 organization
I20170223002188 WA Practitioner - Neurology 7911150065 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
New York University Medical College - NLG, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

Lake Oswego, OR 97035

Portland, OR 97212

1321 NE 99TH Ave
Suite 200
Portland, OR 97220-9439
Phone (503) 215-4250

2801 St Anthony Way
Pendleton, OR 97801-3800
Phone (541) 276-5121

4101 NE Stanton St
Portland, OR 97212-2959

4805 NE Glisan St
Portland, OR 97213-2933

5050 NE Hoyt St
Portland, OR 97213-2982

5050 NE Hoyt St
Suite 454
Portland, OR 97213-2984
Phone (503) 215-6405

5050 NE Hoyt St
Suite 615
Portland, OR 97213-2958
Phone (503) 215-8580

9205 SW Barnes Rd
Portland, OR 97225-6603

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
108649AKMDNeurology Physician
A140879CAMDNeurology Physician
39857MTMDNeurology Physician
MD60478521WAMDNeurology Physician
MD159845ORMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince May 21, 2017 Accepting new patients
Providence Health & Services- Washington CurrentSince Dec 21, 2016 Accepting new patients
Providence Health & Services Mt Current Accepting new patients
Providence Health & Services Washington CurrentSince Dec 21, 2016 Accepting new patients
Providence Health & Services Washington CurrentSince Dec 21, 2016 Accepting new patients
Providence Health & Services Mt CurrentSince Dec 1, 2016 Accepting new patients
Providence Health & Services Mt CurrentSince Dec 1, 2016 Accepting new patients
Swedish Health Services CurrentSince Jan 12, 2023 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 12, 2013 Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 12, 2013 Accepting new patients
Providence Health & Services - Oregon CurrentSince May 21, 2017 Accepting new patients
Providence Health & Services - Washington CurrentSince Dec 21, 2016 Accepting new patients

Locations

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

2801 St Anthony Way
Pendleton, OR 97801
Phone (541) 276-5121

10330 SE 32nd Ave
Ste 205
Portland, OR 97222
Phone (503) 513-8950

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

5050 NE Hoyt St
Ste 315
Portland, OR 97213
Phone (503) 215-8580

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

800 5th Ave
#900
Seattle, WA 98104

101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181

380 Chase Ave
Walla Walla, WA 99362
Phone (509) 526-3333

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669334400000",
    "number": "1063657328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT",
            "address_2": "SUITE 315",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132982",
            "telephone_number": "503-215-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONTAL",
        "first_name": "ANDREW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-15",
        "last_updated": "2022-11-25",
        "certification_date": "2022-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MT",
            "license": "39857",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AK",
            "license": "108649",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD60478521",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A140879",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD159845",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "OR",
            "license": "MD159845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE (PH&S)-PMG",
            "identifier": "P01355678",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500653063",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arontal136909@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5050 NE HOYT",
            "address_2": "SUITE 315",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132982",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arontal136909@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "101 W 8th Ave",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992042307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arontal136909@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "800 5th Ave # 900",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981043176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.