Thomas William Konowalchuk, MD, JD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

15049 Issued in OR

Practice address

1070 NE 7TH Dr
Newport, OR 97365-2518

Phone

(541) 265-3804

NPI assigned

Sep 27, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Juris Doctor, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  OR, Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1679856439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 NE 7TH DR",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973652518",
            "telephone_number": "541-265-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 NE 7TH DR",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973652518",
            "telephone_number": "541-265-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONOWALCHUK",
        "first_name": "THOMAS",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD, JD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-27",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "OR",
            "license": "15049",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OR",
            "license": "15049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Kraft Kirwan, QMHP
• Emily Klipfel, MS, ACSM-CEP
• Mekenzie Spencer Johnston Kmack, CRNA
• Marcus Eugene Kohout, D.P.T.
• Dorcas Marlene Koker
• Daniel Duane Kort, M.D.
• Karen G. Kozick, RD, CDE
• Sue F. Kreul, ANP
• Amber Consuelo Kumar
• Cathy Kwapinski, RN, M.S.

• General Practice Physician in Newport, OR
• Providers in Newport, OR by specialty
• General Practice Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.