NPIMap

Organization Active NPI

Kaiser Foundation Health Plan of the Northwest

Doing business as Care Essentials by Kaiser Permanente - Hawthorne

  • General Practice Physician
  • Portland, OR
National Provider Identifier
1063990695
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Doing business as
Care Essentials by Kaiser Permanente - Hawthorne
Practice address
3060 SE Hawthorne Blvd
Portland, OR 97214-4121
Phone
(800) 813-2000
Fax
(503) 286-6879
NPI assigned
Aug 6, 2018
Last updated
Jun 1, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWESTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Authorized official

Name
Stephen Shawn Barton
Title
Executive Director, Revenue Cycle
Phone
(503) 813-2440

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

3060 SE Hawthorne Blvd
Portland, OR 97214-4121

Mailing address

500 NE Multnomah St
Portland, OR 97232-2023
Phone (800) 813-2000

Other identifiers 1

IdentifierTypeStateIssuer
500728475MedicaidOR

Other names 1

  • CARE ESSENTIALS BY KAISER PERMANENTE - HAWTHORNE Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040130000799 OR Part B Supplier - Clinic/Group Practice 5799688230 Receives reassigned benefits from 3,391 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Portland, OR; Salem, OR; Tigard, OR; Tualatin, OR; Mount Angel, OR; Beaverton, OR; Clackamas, OR; Eugene, OR…

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Kaiser Permenente

Locations

10163 SE Sunnyside Rd
Ste 490
Clackamas, OR 97015
Phone (503) 513-4400

3325 N Interstate Ave
Portland, OR 97227
Phone (503) 285-9321

Practitioners & affiliated clinicians

Practitioners 260

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 260

NPI Registry JSON

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1063990695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322023",
            "telephone_number": "800-813-2000",
            "fax_number": "503-286-6879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 SE HAWTHORNE BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144121",
            "telephone_number": "800-813-2000",
            "fax_number": "503-286-6879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST",
        "enumeration_date": "2018-08-06",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "BARTON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, REVENUE CYCLE",
        "authorized_official_telephone_number": "503-813-2440"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500728475",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3060 SE Hawthorne Blvd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972144121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "CARE ESSENTIALS BY KAISER PERMANENTE - HAWTHORNE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CARE ESSENTIALS BY KAISER PERMANENTE - HAWTHORNE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.