Individual provider Active NPI

Andrea C. Tongue, M.D.

  • Ophthalmology Physician
  • Lake Oswego, OR
National Provider Identifier
1306892682
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD07840 Issued in OR
Practice address
4035 Mercantile Dr
Suite 201
Lake Oswego, OR 97035-2546
Phone
(503) 635-4436
Fax
(503) 635-7356
NPI assigned
May 26, 2006
Last updated
Oct 30, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD07840 OR Primary

Addresses

Primary practice location

4035 Mercantile Dr
Suite 201
Lake Oswego, OR 97035-2546

Mailing address

4035 Mercantile Dr
Suite 201
Lake Oswego, OR 97035-2546
Phone (503) 635-4436

Other identifiers 1

IdentifierTypeStateIssuer
196949MedicaidOR

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7840ORMDSpecialist
MD07840ORMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Child Eye Care Associates, LLC Ophthalmology PastSince Jan 1, 2003 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1306892682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4035 MERCANTILE DR",
            "address_2": "SUITE 201",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352546",
            "telephone_number": "503-635-4436",
            "fax_number": "503-635-7356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 MERCANTILE DR",
            "address_2": "SUITE 201",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352546",
            "telephone_number": "503-635-4436",
            "fax_number": "503-635-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONGUE",
        "first_name": "ANDREA",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "MD07840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196949",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.

Verify at the official NPI Registry.