Active NPI
Andrea C. Tongue, M.D.
- Ophthalmology Physician
- Lake Oswego, OR
National Provider Identifier
1306892682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MD07840
- 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, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 196949 | Medicaid | OR |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7840 | OR | MD | Specialist |
| MD07840 | OR | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Child Eye Care Associates, LLC | Ophthalmology | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Ophthalmology Physician
- Tigard, OR
- NPI 1417016429
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.