Aumyot Prongdong, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD176147 Issued in OR

Practice address

10201 SE Main St Ste 27
Portland, OR 97216-2937

Phone

(503) 256-0877

Fax

(503) 256-4188

NPI assigned

May 21, 2008

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: aumyot.prongdong@direct.myteamcare.com

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1881851368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 NW 22ND AVE STE 640",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102993",
            "telephone_number": "503-229-7976",
            "fax_number": "503-274-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 SE MAIN ST STE 27",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162937",
            "telephone_number": "503-256-0877",
            "fax_number": "503-256-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRONGDONG",
        "first_name": "AUMYOT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "HI",
            "license": "MD-20827",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OR",
            "license": "MD176147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ingmar Klaseen Prokop, M.D.
• Joao Prola Netto, M.D.
• Prolific Wellness
• Promuveo LLC
• Jordin Whitney Pronath-Holden
• Justin Eric Pronovost
• Bridgette Alexandra Pronozuk
• Nicole Propert
• Nicole Prophet, MS, LPC
• William Mark Proppe, LMT

• Nephrology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Nephrology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.