Individual provider Active NPI

Mandeep K Kingra, MD

  • Obstetrics & Gynecology Physician
  • Milwaukie, OR
National Provider Identifier
1750693602
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD194318 Issued in OR
Practice address
10330 SE 32ND Ave Ste 305
Milwaukie, OR 97222-6596
Phone
(503) 513-1800
NPI assigned
Jul 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD60575930 WA
Obstetrics & Gynecology Physician 207V00000X MD194318 OR Primary

Addresses

Primary practice location

10330 SE 32ND Ave Ste 305
Milwaukie, OR 97222-6596

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

1 E Main St
Auburn, WA 98002-4905
Phone (253) 939-9654

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mkingra1154463@oc.providencedirect.org
Direct Messaging Address mkingra1154463@oc.providencedirect.org

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
I20191104001159 OR Practitioner - Obstetrics/Gynecology 0648462473 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10330 SE 32ND Ave
Suite 305
Milwaukie, OR 97222-6596
Phone (503) 513-1800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD194318ORMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Obstetrics & Gynecology Current Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 1, 2019 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 1, 2019 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2019 Accepting new patients
Providence Health & Services Oregon Obstetrics & Gynecology CurrentSince Sep 1, 2019 Accepting new patients
Providence Health & Services - Oregon Family Medicine CurrentSince Sep 1, 2019 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 1, 2019 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Family Medicine Past Accepting new patients

Locations

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

10330 SE 32nd Ave
Ste 305
Milwaukie, OR 97222
Phone (503) 408-4078

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

545 NE 47th Ave
Ste 102
Portland, OR 97213
Phone (503) 215-6262

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

Interoperability endpoints

  • Direct secure messaging: mkingra1154463@oc.providencedirect.org

Organizations & group practices 9

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": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1750693602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10330 SE 32ND AVE STE 305",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226596",
            "telephone_number": "503-513-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 E Main St",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "WA",
            "postal_code": "980024905",
            "country_code": "US",
            "telephone_number": "253-939-9654",
            "fax_number": "253-939-6549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINGRA",
        "first_name": "MANDEEP",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD60575930",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "MD194318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkingra1154463@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "10330 SE 32nd Ave Ste 305",
            "city": "Milwaukie",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972226596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkingra1154463@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "545 NE 47th Ave Ste 102",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

Verify at the official NPI Registry.