NPIMap

Individual provider Active NPI

Sophia Ying Fang, MD, MS

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Tigard, OR
National Provider Identifier
1942507447
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X
License
MD198768 Issued in OR
Practice address
9735 SW Shady LN Ste 203
Tigard, OR 97223-5481
Phone
(503) 635-4436
Fax
(971) 317-0283
NPI assigned
Feb 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Ophthalmology and Strabismus Specialist Physician 207WX0110X MD198768 OR Primary
Ophthalmology Physician 207W00000X 10772872-1205 UT
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

9735 SW Shady LN Ste 203
Tigard, OR 97223-5481

Mailing address

14521 265TH PL NE
Duvall, WA 98019-8363
Phone (213) 663-7484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180628000409 UT Practitioner - Ophthalmology 2860748241 Reassigns benefits to 3 organizations
I20200926000052 OR Practitioner - Ophthalmology 2860748241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of California, Davis School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Child Eye Care Associates LLCGroup PAC ID 6002999257, 3 clinicians

Practice addresses (Care Compare)

9735 SW Shady LN
Suite 203
Tigard, OR 97223-5481
Phone (503) 635-4436

Hospital & facility affiliations

  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10772872-1205UTMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Aug 19, 2018 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
University of Utah Pediatric Services CurrentSince May 12, 2018 Accepting new patients
University of Utah Pediatric Services Ophthalmology CurrentSince May 12, 2018 Accepting new patients
University of Utah Adult Services CurrentSince Aug 19, 2018 Accepting new patients
University of Utah CurrentSince May 12, 2018 Accepting new patients
University of Utah CurrentSince May 12, 2018 Accepting new patients

Locations

3741 W 12600 S
Riverton, UT 84065
Phone (801) 285-2400

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1942507447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14521 265TH PL NE",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "980198363",
            "telephone_number": "213-663-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9735 SW SHADY LN STE 203",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235481",
            "telephone_number": "503-635-4436",
            "fax_number": "971-317-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANG",
        "first_name": "SOPHIA",
        "middle_name": "YING",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "OR",
            "license": "MD198768",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "10772872-1205",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.