Organization Active NPI

Cassandra Tomczak, DPM PC

  • Podiatrist
  • Portland, OR
National Provider Identifier
1891225181
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DP164497 Issued in OR
Legal business name
CASSANDRA TOMCZAK, DPM PC
Practice address
501 N Graham St Ste 250
Portland, OR 97227-1651
Phone
(503) 249-0719
Fax
(503) 249-0749
NPI assigned
Jun 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Andrea Wolfe
Title
Manager
Phone
(503) 249-0719

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X DP164497 OR Primary

Addresses

Primary practice location

501 N Graham St Ste 250
Portland, OR 97227-1651

Mailing address

501 N Graham St Ste 250
Portland, OR 97227-1651
Phone (503) 249-0719

Other identifiers 1

IdentifierTypeStateIssuer
500661451MedicaidOR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1891225181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST STE 250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271651",
            "telephone_number": "503-249-0719",
            "fax_number": "503-249-0749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N GRAHAM ST STE 250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271651",
            "telephone_number": "503-249-0719",
            "fax_number": "503-249-0749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASSANDRA TOMCZAK, DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-249-0719"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP164497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500661451",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.