Individual provider Active NPI

Kyle Ivy Fuchs, M.D.

  • Specialist
  • Portland, OR
National Provider Identifier
1063503100
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
12687 Issued in OR
Practice address
9427 S.W. Barnes Road
Portland, OR 97225-7225
Phone
(503) 571-2727
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 12687 OR Primary
Specialist 174400000X 00034920 WA

Addresses

Primary practice location

9427 S.W. Barnes Road
Portland, OR 97225-7225

Mailing address

1620 N.W. Walmer Drive
Portland, OR 97229
Phone (503) 292-1554

Other names 1

  • Kyle Ivy Cohen Former name

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
I20071211000274 OR Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 2466541602 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12687ORMDSpecialist
00034920WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Nov 17, 2009 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Nov 17, 2009 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Current Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

9427 SW Barnes Rd
Portland, OR 97225
Phone (503) 203-2040

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063503100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 N.W. WALMER DRIVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97229",
            "telephone_number": "503-292-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9427 S.W. BARNES ROAD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972257225",
            "telephone_number": "503-571-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUCHS",
        "first_name": "KYLE",
        "middle_name": "IVY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "12687",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "00034920",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLE",
            "last_name": "COHEN",
            "middle_name": "IVY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.