Michelle Fong

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3282 Issued in OR

Practice address

534 Pleasant View Way NW Ste 200
Albany, OR 97321-1789

Phone

(541) 812-5760

NPI assigned

May 27, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Public Hospital District 1-a of Whitman CountyGroup PAC ID 8325934987, 86 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pullman Regional Hospital Hospital, Pullman, WA, CCN 501331

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mfong156703@samhealth.direct-ci.com

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.

• Public Hospital District #1-a of Whitman County

  • Critical Access Hospital
  • Pullman, WA
  • NPI 1366446767
  Medicare reassignment Care Compare group NPD
• Public Hospital District #1-a of Whitman County

  • Family Medicine Physician
  • Pullman, WA
  • NPI 1881475051
  NPD
• Albany General Hospital

  • Clinical Neuropsychologist
  • Albany, OR
  • NPI 1609265123
  NPD (past)
• Oslc Community Programs

  • Adolescent and Children Mental Health Clinic/Center
  • Eugene, OR
  • NPI 1295747186
  NPD (past)
• Public Hospital District #1-a of Whitman County

  • Medicare Defined Swing Bed Hospital Unit
  • Pullman, WA
  • NPI 1750401006
  NPD (past)

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

• Public Hospital District #1-a of Whitman County

  • Critical Access Hospital
  • Pullman, WA
  • NPI 1366446767
  Care Compare affiliation

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1821477514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1188",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 PLEASANT VIEW WAY NW STE 200",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211789",
            "telephone_number": "541-812-5760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1170 Pearl St",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974013541",
            "country_code": "US",
            "telephone_number": "541-743-4340",
            "fax_number": "541-743-4369",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5940 Ulali Dr NE",
            "address_purpose": "LOCATION",
            "city": "Keizer",
            "state": "OR",
            "postal_code": "973031500",
            "country_code": "US",
            "telephone_number": "971-358-0622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONG",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-27",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "3282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfong156703@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "534 Pleasant View Way NW Ste 200",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amber Fleming, PT
• Steven Richard Fletcher, MD
• Tyson Flohr, CRNA
• David Floyd, MD
• Timothy Edward Flynn, B.A. PHILOSOPHY, CRM
• Margaret Forbes, OTR/L
• Annamarie Ford
• Chelsea L Foreman, M.D.
• Christine Forester
• Steven Eugene Forester, R.PH.

• Psychologist in Albany, OR
• Providers in Albany, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.