Tej Miguel Pereira Ambrose

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

9125 SW 55TH Ave
Portland, OR 97219-5018

Phone

(503) 477-4622

NPI assigned

Apr 13, 2021

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 names 1

• Mara Ambrose Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Cascadia Health

  • Community/Behavioral Health Agency
  • Portland, OR
  • NPI 1003217761
  NPD

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1982284865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9125 SW 55TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972195018",
            "telephone_number": "503-477-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "TEJ MIGUEL",
        "middle_name": "PEREIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARA",
            "last_name": "AMBROSE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Amber Wellness Group
• Lanette Kanika Ambers, MSW
• Branden William Ambert, PSS
• Jacklyn Amberwood, LCSW
• Emily Ambler
• Mandy N Ambroz, CPHT
• Ambulatory Surgical Center
• Amedisys Oregon, L.L.C.
• Emily Amen, LMT
• Amanda Amendola, MSW

• All providers in Portland, OR
• Personal Care Attendant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.