Individual provider Active NPI

Mary Lou Tongay, FNP-C

  • Family Nurse Practitioner
  • Park Hills, MO
National Provider Identifier
1386192151
Registry record updated May 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016032820 Issued in MO
Practice address
4800 Oak Ridge TRL
Park Hills, MO 63601-8224
Phone
(573) 315-9567
NPI assigned
Sep 21, 2016
Last updated
May 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2016032820 MO Primary

Addresses

Primary practice location

4800 Oak Ridge TRL
Park Hills, MO 63601-8224

Mailing address

111 W Port PLZ
Ste 600
Saint Louis, MO 63146-3015
Phone (480) 862-1677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170526001879 MO Practitioner - Nurse Practitioner 9436426236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson County Health DepartmentGroup PAC ID 7618056011, 2 clinicians

Practice addresses (Care Compare)

1818 Lonedell Rd
Arnold, MO 63010-1050
Phone (636) 797-3737

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2016032820MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson County Health Departmet Past Accepting new patients
Compass Health, Inc PastSince Dec 17, 2018 Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525305600000",
    "number": "1386192151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W PORT PLZ",
            "address_2": "STE 600",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463015",
            "telephone_number": "480-862-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 OAK RIDGE TRL",
            "city": "PARK HILLS",
            "state": "MO",
            "postal_code": "636018224",
            "telephone_number": "573-315-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONGAY",
        "first_name": "MARY",
        "middle_name": "LOU",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2018-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016032820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Hills, MO

Sources for this page

Verify at the official NPI Registry.