NPIMap

Individual provider Active NPI

Amanda Ngouajio, MD

  • Otolaryngology Physician
  • Portland, OR
National Provider Identifier
1548799174
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
R-10996 Issued in IA
Practice address
2222 NW Lovejoy St Ste 607
Portland, OR 97210-5104
Phone
(503) 222-3638
Fax
(503) 223-5139
NPI assigned
Jun 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X R-10996 IA
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X R-10996 IA
Otolaryngology Physician 207Y00000X R-10996 IA Primary
Sleep Medicine (Otolaryngology) Physician 207YS0012X R-10996 IA
Facial Plastic Surgery Physician 207YS0123X R-10996 IA
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X R-10996 IA
Otolaryngic Allergy Physician 207YX0602X R-10996 IA
Otology & Neurotology Physician 207YX0901X R-10996 IA

Addresses

Primary practice location

2222 NW Lovejoy St Ste 607
Portland, OR 97210-5104

Mailing address

2222 NW Lovejoy St Ste 607
Portland, OR 97210-5104
Phone (503) 222-3638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240531002156 OR Practitioner - Otolaryngology 1456622497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Indiana University School of Medicine, 2017
Medicare assignment
May accept Medicare assignment
Group practices
PDX ENT and Audiology Medical Group PCGroup PAC ID 8820397086, 8 clinicians

Practice addresses (Care Compare)

2222 NW Lovejoy St
Suite 607
Portland, OR 97210-5104
Phone (503) 222-3638

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1548799174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST STE 607",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105104",
            "telephone_number": "503-222-3638",
            "fax_number": "503-223-5139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST STE 607",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105104",
            "telephone_number": "503-222-3638",
            "fax_number": "503-223-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGOUAJIO",
        "first_name": "AMANDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "IA",
            "license": "R-10996",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "IA",
            "license": "R-10996",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IA",
            "license": "R-10996",
            "primary": true
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "IA",
            "license": "R-10996",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "IA",
            "license": "R-10996",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "IA",
            "license": "R-10996",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "IA",
            "license": "R-10996",
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "IA",
            "license": "R-10996",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.