Individual provider Active NPI

Andrew Frederick Nelson, M.D.

  • Diagnostic Radiology Physician
  • Tillamook, OR
National Provider Identifier
1073726584
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD154646 Issued in OR
Practice address
1000 Third Street
Tillamook, OR 97141
Phone
(503) 842-4444
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A93516 CA
Diagnostic Radiology Physician 2085R0202X MD154646 OR Primary

Addresses

Primary practice location

1000 Third Street
Tillamook, OR 97141

Mailing address

1000 Third Street
Tillamook, OR 97141
Phone (503) 842-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120709000291 OR Practitioner - Diagnostic Radiology 0648435149 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Loma Linda University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 3Rd St
Tillamook, OR 97141-3430
Phone (503) 815-2260

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.81 of 100Reported as group
Quality
71.23
Promoting interoperability
88
Improvement activities
40
Cost
81.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A93516CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Medical Foundation of Tillamook CurrentSince Jul 1, 2012 Accepting new patients
Northwest Medical Foundation of Tillamook CurrentSince Jul 1, 2012 Accepting new patients
Northwest Medical Foundation of Tillamook CurrentSince Jan 1, 2026 Accepting new patients
Northwest Medical Foundation of Tillamook Current Accepting new patients

Locations

1000 3rd St
#M
Tillamook, OR 97141
Phone (503) 815-2260

1000 3rd St
Tillamook, OR 97141
Phone (503) 251-6129

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1073726584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 THIRD STREET",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "97141",
            "telephone_number": "503-842-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 THIRD STREET",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "97141",
            "telephone_number": "503-842-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ANDREW",
        "middle_name": "FREDERICK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A93516",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD154646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tillamook, OR

Sources for this page

Verify at the official NPI Registry.