Individual provider Active NPI

Thor Tangvald IV, M.D.

  • Psychiatry Physician
  • Cincinnati, OH
National Provider Identifier
1235287954
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA11553500 Issued in NJ
Practice address
3200 Burnet Ave
Cincinnati, OH 45229-3019
Phone
(513) 558-7700
Fax
(513) 558-5055
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35.059078 OH
Psychiatry Physician 2084P0800X 25MA11553500 NJ Primary
Psychiatry Physician 2084P0800X 33141 KY

Addresses

Primary practice location

3200 Burnet Ave
Cincinnati, OH 45229-3019

Mailing address

PO Box 636256
Cincinnati, OH 45263-6256
Phone (513) 585-6200

Other practice location 1

103 Landmark Dr
Suite 240
Bellevue, KY 41073-1393
Phone (859) 292-3900

Other identifiers 1

IdentifierTypeStateIssuer
64938137MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OH, NJ3 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
I20171006001311 WA Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 0143269258 Reassigns benefits to 1 organization
I20200219002601 OH Practitioner - Psychiatry 0143269258 Reassigns benefits to 1 organization
I20230201000037 NJ Practitioner - Psychiatry 0143269258 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
West Virginia University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3188 Bellevue Ave
Cincinnati, OH 45219-2369
Phone (513) 584-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33141KYMDPsychiatry Physician
25MA11553500NJMDPsychiatry Physician
35.059078OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BHC Fairfax Hospital Inc. Psychiatry CurrentSince Aug 24, 2017 Accepting new patients
University of Cincinnati Medical Center, LLC Current Accepting new patients
University of Cincinnati Physicians Company, LLC Psychiatry CurrentSince Mar 1, 2025 Accepting new patients
State of New Jersey Omb Centralized Payroll CurrentSince Sep 21, 2022 Accepting new patients
Barnabas Health Medical Group, PC CurrentSince Jan 20, 2026 Accepting new patients
University Surgical-Dental Associates, LLC Past Accepting new patients
University of Cincinnati Medical Center, LLC Past Accepting new patients
Trinitas Regional Medical Center Past Accepting new patients

Locations

7388 Turfway Rd
Ste 201
Florence, KY 41042
Phone (606) 746-6200

1 Clara Maass Dr
Belleville, NJ 07109
Phone (973) 450-2008

59 Koch Ave
Morris Plains, NJ 07950
Phone (973) 889-4390

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

3200 Burnet Ave
Cincinnati, OH 45229
Phone (513) 558-7700

3200 Burnet Ave
#2
Cincinnati, OH 45229
Phone (513) 585-5505

916 Pacific Ave
Fl 7
Everett, WA 98201
Phone (425) 303-6500

10200 NE 132nd St
Kirkland, WA 98034
Phone (425) 821-2000

Organizations & group practices 8

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 2

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1235287954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636256",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636256",
            "telephone_number": "513-585-6200",
            "fax_number": "513-245-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 BURNET AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293019",
            "telephone_number": "513-558-7700",
            "fax_number": "513-558-5055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Landmark Dr",
            "address_2": "SUITE 240",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "KY",
            "postal_code": "410731393",
            "country_code": "US",
            "telephone_number": "859-292-3900",
            "fax_number": "859-292-3903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANGVALD",
        "first_name": "THOR",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.059078",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA11553500",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "33141",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64938137",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.