Mary K. Tegger, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

152807 Issued in OR

Practice address

619 NW 6TH Ave FL 3
Portland, OR 97209-3964

Phone

(503) 988-5020

Fax

(503) 988-5022

NPI assigned

Aug 2, 2006

Last updated

Jan 14, 2020By the provider in NPPES

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

Other identifiers 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Multnomah CountyGroup PAC ID 6608771787, 111 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mtegger22744@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Multnomah County

  dba Multnomah County Health Dept, North Portland

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1609914787
  Medicare reassignment Care Compare group
• Multnomah County

  dba Multnomah County Health Department,PH

  • State or Local Public Health Clinic/Center
  • Portland, OR
  • NPI 1275702201
  NPD
• Multnomah County

  • Federally Qualified Health Center (FQHC)
  • Gresham, OR
  • NPI 1912322074
  NPD
• Multnomah County

  dba Multnomah County Health Dept, Westside

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1336287416
  NPD (past)

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1902813736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 NW 6TH AVE FL 5",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 NW 6TH AVE FL 3",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093964",
            "telephone_number": "503-988-5020",
            "fax_number": "503-988-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEGGER",
        "first_name": "MARY",
        "middle_name": "K.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "152807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022959",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON PA LICENSE",
            "identifier": "152807",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eve Teeter-Balin, MS, NP-C
• David M. Teeter, DMD, MSD
• Jessie Tefft, OTR/L
• Noah P Tefft
• Michelle Tegenkamp, MS, RD, LD
• Gerda Brigitta Teglassy, MD
• Anne C Tegtmeier, LMT
• Sepehr Saber Tehrani, MD
• Noah Benjamin Teicher, MSW
• Seth S Teige

• Medical Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.