Individual provider Active NPI

Paul Chien-Chung Tseng, M.D.

  • Gynecologic Oncology Physician
  • Wauwatosa, WI
National Provider Identifier
1811990484
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
MD16438 Issued in OR
Practice address
201 N Mayfair Rd
Wauwatosa, WI 53226-4216
Phone
(414) 585-1949
Fax
(414) 585-1516
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X MD16438 OR Primary

Addresses

Primary practice location

201 N Mayfair Rd
Wauwatosa, WI 53226-4216

Mailing address

201 N Mayfair Rd
Wauwatosa, WI 53226-4216
Phone (414) 585-1949

Other practice location 1

265 N Broadway St
Portland, OR 97227-1800
Phone (503) 274-4885

Other identifiers 2

IdentifierTypeStateIssuer
004312MedicaidOR
1019685MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040308001286 OR Practitioner - Gynecological Oncology 1951299213 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16438ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Mar 29, 2022 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Mar 29, 2022 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince May 4, 2022 Accepting new patients
Legacy Clinics LLC CurrentSince Jul 1, 2015 Accepting new patients

Locations

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1040 NW 22nd Ave
Ste 440
Portland, OR 97210
Phone (503) 413-8654

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

19333 W North Ave
Brookfield, WI 53045
Phone (262) 785-2000

2350 N Lake Dr
Ste G1
Milwaukee, WI 53211
Phone (414) 291-1556

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

201 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 259-7200

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Interoperability endpoints

  • Direct secure messaging: ptseng8457@direct.lhs.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1811990484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264216",
            "telephone_number": "414-585-1949",
            "fax_number": "414-585-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264216",
            "telephone_number": "414-585-1949",
            "fax_number": "414-585-1516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "265 N Broadway St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271800",
            "country_code": "US",
            "telephone_number": "503-274-4885",
            "fax_number": "503-274-4814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TSENG",
        "first_name": "PAUL",
        "middle_name": "CHIEN-CHUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "OR",
            "license": "MD16438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004312",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019685",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.