Mark Leo McKinstry, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

16271 Issued in OR

Practice address

19875 SW 65TH Ave
Tualatin, OR 97062-8353

Phone

(503) 692-7785

Fax

(503) 885-1663

NPI assigned

Mar 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Legacy Meridian Park Hospital

  • Hospitalist Physician
  • Tualatin, OR
  • NPI 1023305034
  NPD (past)
• Legacy Meridian Park Pediatric Rehab

  • Children's Rehabilitation Hospital
  • Tualatin, OR
  • NPI 1801122593
  NPD (past)

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298592000000",
    "number": "1073582383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19875 SW 65TH AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628353",
            "telephone_number": "503-692-7785",
            "fax_number": "503-885-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19875 SW 65TH AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628353",
            "telephone_number": "503-692-7785",
            "fax_number": "503-885-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINSTRY",
        "first_name": "MARK",
        "middle_name": "LEO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2011-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "16271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028063",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Anne McDuffee
• Alison M McEwing, LPC
• Jethro Houston McFarland, DC
• Rebecca McKasson
• Mary Suzanne McKenzie, MD
• Kendall Leigh McMahon, REGISTERED ASSOCIATE
• Michael T McNicholas
• Margaret Mary McSorley, CRNA
• Meadow Health LLC
• Sara Meerdter

• Internal Medicine Physician in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.