Individual provider Active NPI

Elizabeth Ann Tindall, M.D.

  • Rheumatology Physician
  • Hillsboro, OR
National Provider Identifier
1457589236
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
11344 Issued in OR
Practice address
6355 NE Cornell Rd
Suite 100
Hillsboro, OR 97124-5434
Phone
(503) 597-3130
Fax
(503) 597-3140
NPI assigned
Jun 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 11344 OR Primary

Addresses

Primary practice location

6355 NE Cornell Rd
Suite 100
Hillsboro, OR 97124-5434

Mailing address

1980 Willamette Falls Dr
Suite 230
West Linn, OR 97068-4668
Phone (503) 638-3987

Other identifiers 1

IdentifierTypeStateIssuer
265074MedicaidOR

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11344ORMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Rheumatology Clinic LLC Rheumatology Past Accepting new patients
Deschutes Rheumatology, LLC Rheumatology PastSince Jun 1, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1457589236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 WILLAMETTE FALLS DR",
            "address_2": "SUITE 230",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970684668",
            "telephone_number": "503-638-3987",
            "fax_number": "503-638-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 NE CORNELL RD",
            "address_2": "SUITE 100",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245434",
            "telephone_number": "503-597-3130",
            "fax_number": "503-597-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINDALL",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OR",
            "license": "11344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265074",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; 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.