Individual provider Active NPI

David Alexander Kidd, MD

  • Pulmonary Disease Physician
  • Beaverton, OR
National Provider Identifier
1053733774
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD213894 Issued in OR
Practice address
11000 SW Stratus St Ste 310
Beaverton, OR 97008-7144
Phone
(503) 297-3778
Fax
(503) 297-7853
NPI assigned
Jan 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 036152339 IL
Pulmonary Disease Physician 207RP1001X MD213894 OR Primary

Addresses

Primary practice location

11000 SW Stratus St Ste 310
Beaverton, OR 97008-7144

Mailing address

541 NE 20TH Ave Ste 225
Portland, OR 97232-2895
Phone (503) 963-2801

Other practice location 1

879 N Providence Dr
Newberg, OR 97132-7563
Phone (503) 297-3778

Other identifiers 2

IdentifierTypeStateIssuer
500244423MedicaidOR
2257691MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cc_otoc_pulmonology_west_front_desk12223305@oc.providencedirect.org The Oregon Clinic PC

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
I20230829003288 OR Practitioner - Pulmonary Disease 9436426087 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Johns Hopkins University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Oregon Clinic, PCGroup PAC ID 2860390408, 353 clinicians

Practice addresses (Care Compare)

11000 SW Stratus St
Suite 310
Beaverton, OR 97008-7144
Phone (503) 297-3778

500N Columbia River Hwy
Saint Helens, OR 97051-1299
Phone (503) 274-4999

5050 NE Hoyt
Suite 655
Portland, OR 97213-2990
Phone (503) 239-6673

Hospital & facility affiliations

  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037
  • Providence Seaside Hospital Hospital, Seaside, OR, CCN 381303
  • Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036152339ILMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Oregon Clinic PC Pulmonary Disease Current Accepting new patients
Oregon Clinic PC CurrentSince May 1, 2024 Accepting new patients
The Oregon Clinic, PC CurrentSince May 1, 2024 Accepting new patients
Legacy Clinics LLC CurrentSince Aug 16, 2023 Accepting new patients

Locations

879 N Providence Dr
Newberg, OR 97132
Phone (503) 297-3778

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

541 NE 20th Ave
Ste 225
Portland, OR 97232
Phone (503) 963-2801

5050 NE Hoyt St
Ste 655
Portland, OR 97213
Phone (503) 239-6673

9427 SW Barnes Rd
Ste 296
Portland, OR 97225
Phone (503) 297-3778

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

500 N Highway
Saint Helens, OR 97051
Phone (503) 229-7554

Networks

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

Interoperability endpoints

  • Direct secure messaging: dkidd3183247@oc.providencedirect.org

Organizations & group practices 4

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 5

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": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1053733774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 NE 20TH AVE STE 225",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322895",
            "telephone_number": "503-963-2801",
            "fax_number": "503-963-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 SW STRATUS ST STE 310",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087144",
            "telephone_number": "503-297-3778",
            "fax_number": "503-297-7853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "879 N Providence Dr",
            "address_purpose": "LOCATION",
            "city": "Newberg",
            "state": "OR",
            "postal_code": "971327563",
            "country_code": "US",
            "telephone_number": "503-297-3778",
            "fax_number": "503-297-7853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIDD",
        "first_name": "DAVID",
        "middle_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-15",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036152339",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "MD213894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500244423",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2257691",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cc_otoc_pulmonology_west_front_desk12223305@oc.providencedirect.org",
            "affiliation": "Y",
            "affiliationName": "The Oregon Clinic PC",
            "address_1": "11000 SW Stratus St Ste 310",
            "city": "Beaverton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970087144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.