Individual provider Active NPI

Nicholas Aloisius Kuhn, MD

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1053457937
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD160278 Issued in OR
Practice address
2400 SW Vermont St
Portland, OR 97219-1940
Phone
(503) 452-0915
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0600003443 VT
Internal Medicine Physician 207R00000X MD160278 OR Primary

Addresses

Primary practice location

2400 SW Vermont St
Portland, OR 97219-1940

Mailing address

2400 SW Vermont St
Portland, OR 97219-1940
Phone (503) 452-0915

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121219000512 OR Practitioner - Internal Medicine 0648326660 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Colorado School of Medicine, Denver, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fanno Creek Clinic LLCGroup PAC ID 0042100521, 24 clinicians

Practice addresses (Care Compare)

2400 SW Vermont St
Portland, OR 97219-1940
Phone (503) 452-0915

Hospital & facility affiliations

  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD160278ORMDInternal Medicine Physician
0600003443VTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fanno Creek Clinic LLC Internal Medicine CurrentSince Dec 1, 2012 Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Jan 16, 2013 Accepting new patients

Locations

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2400 SW Vermont St
Portland, OR 97219
Phone (503) 452-0915

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
  • WA PPO C-SNP

Organizations & group practices 2

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 3

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1053457937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 SW VERMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972191940",
            "telephone_number": "503-452-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 SW VERMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972191940",
            "telephone_number": "503-452-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUHN",
        "first_name": "NICHOLAS",
        "middle_name": "ALOISIUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "0600003443",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD160278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.