Tina Jenq, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

MD28284 Issued in OR

Practice address

10202 SE 32ND Ave
Ste 702
Portland, OR 97222-3610

Phone

(503) 400-6622

Fax

(503) 400-6622

NPI assigned

May 21, 2008

Sex

Female

Sole proprietor

No

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

Specialty

Plastic and Reconstructive Surgery

Education

University of California, Davis School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Milwaukie Hospital Hospital, Milwaukie, OR, CCN 380082
• Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

Medicare enrollment (NPD)

Enrolled

Credentials

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oregon Cosmetic and Reconstructive Clinic, PC

  • Plastic Surgery Physician
  • Milwaukie, OR
  • NPI 1407177934
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services - Oregon

  dba Providence St Vincent Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Care Compare affiliation
• Providence Health & Services Oregon

  dba Providence Milwaukie Hospital

  • General Acute Care Hospital
  • Milwaukie, OR
  • NPI 1366536963
  Care Compare affiliation

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1730346388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5331 SW MACADAM AVE STE 258",
            "address_2": "PMB 429",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393871",
            "telephone_number": "503-400-6622",
            "fax_number": "503-400-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10202 SE 32ND AVE",
            "address_2": "STE 702",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972223610",
            "telephone_number": "503-400-6622",
            "fax_number": "503-400-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENQ",
        "first_name": "TINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD28284",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OR",
            "license": "MD28284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Jennings, ND
• Madeline Rene Jennison, BEHAVIOR TECHNICIAN
• Zina Jenny
• Jennybird Speech & Language, LLC
• Jennyhelm, Inc. (Structural Healing Massage and Bodywork, Inc.)
• Amariek Jane Jensen-de la Cruz, M.D.
• Diane Michelle Jensen-Rucker, LMT
• Amanda Jensen, PA-C
• Anita Jensen
• Carl James Jensen

• Plastic Surgery Physician in Portland, OR
• Providers in Portland, OR by specialty
• Plastic Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.