Kelly John Caverzagie, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

MD222456 Issued in OR

Practice address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Phone

(503) 494-1164

Fax

(503) 494-5502

NPI assigned

Jun 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Hospitalist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcaverzagie182477@direct.ohsu.edu

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.

• University Professional Services

  • General Practice Physician
  • Portland, OR
  • NPI 1376709535
  Medicare reassignment Care Compare group NPD
• Unmc Physicians

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1417912114
  Medicare reassignment NPD
• University Professional Services

  • Pharmacy
  • Beaverton, OR
  • NPI 1073054714
  NPD
• University Professional Services

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1750753687
  NPD

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

• Oregon Health & Science University

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1609824010
  Care Compare affiliation

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1033158084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-1164",
            "fax_number": "503-494-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-1164",
            "fax_number": "503-494-5502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "988102 Nebraska Medical Center",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681988102",
            "country_code": "US",
            "telephone_number": "402-595-3939",
            "fax_number": "402-595-3898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAVERZAGIE",
        "first_name": "KELLY",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD222456",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "22784",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD426638",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD222456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101537515",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Cavazos, CRM/QMHA-R
• Angela Cave
• Katherine Ellen Cave
• Taylor Cave, MD
• Gina Marie Cavellini, L AC
• Julie Cavese, PSYD, LPC
• Kayla Cavett, LMT
• Christopher Douglas Caviglia
• Elizabeth C Cavin, ND
• Nathan Cavin

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.