Individual provider Active NPI

Minh-Phong Andrew Ngo, MD

  • Family Medicine Physician
  • Dallas, OR
National Provider Identifier
1629530167
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD213024 Issued in OR
Practice address
1000 SE Uglow Ave
Dallas, OR 97338-2645
Phone
(503) 323-8376
Fax
(503) 623-8376
NPI assigned
Apr 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD213024 OR Primary

Addresses

Primary practice location

1000 SE Uglow Ave
Dallas, OR 97338-2645

Mailing address

PO Box 14001
Salem, OR 97309-5014

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230425000984 OR Practitioner - Family Practice 7517322621 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

1000 SE Uglow Ave
Dallas, OR 97338-2645
Phone (503) 623-8376

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Salem, OR, CCN 387136
  • First Call Home Health Agency, LLC Home health agency, Salem, OR, CCN 387147
  • Salem Health West Valley Hospital, Dallas, OR, CCN 381308
  • Salem Hospital Hospital, Salem, OR, CCN 380051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD213024ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health Family Medicine CurrentSince May 25, 2024 Accepting new patients
Salem Health West Valley CurrentSince May 8, 2023 Accepting new patients
Salem Health CurrentSince May 25, 2024 Accepting new patients

Locations

1000 SE Uglow Ave
Dallas, OR 97338
Phone (503) 623-8376

525 SE Washington St
Dallas, OR 97338
Phone (503) 623-7344

1601 Monmouth St
Ste 100
Independence, OR 97351
Phone (503) 623-8301

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

Interoperability endpoints

  • Direct secure messaging: mngo50070@direct.phhs.org
  • Direct secure messaging: mngo350093@direct.salemhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1629530167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14001",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973095014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SE UGLOW AVE",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973382645",
            "telephone_number": "503-323-8376",
            "fax_number": "503-623-8376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "MINH-PHONG",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD213024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, OR

Sources for this page

Verify at the official NPI Registry.