NPIMap

Individual provider Active NPI

Thomas B Knowles, MD

  • Surgery Physician
  • Portland, OR
National Provider Identifier
1114337466
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD60946286 Issued in WA
Practice address
1130 NW 22ND Ave Ste 500
Portland, OR 97210-2976
Phone
(503) 413-5725
NPI assigned
May 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD198666 OR
Surgery Physician 208600000X MD60946286 WA Primary

Addresses

Primary practice location

1130 NW 22ND Ave Ste 500
Portland, OR 97210-2976

Mailing address

1130 NW 22ND Ave Ste 500
Portland, OR 97210-2976
Phone (503) 413-5725

Other practice location 1

1101 Madison St
Ste 900
Seattle, WA 98104-1347
Phone (206) 215-6800

Other identifiers 1

IdentifierTypeStateIssuer
1114337466MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200706002661 OR Practitioner - General Surgery 3678790425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Creighton University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

475 S Columbia River Hwy
Suite 100
Saint Helens, OR 97051-2834
Phone (888) 784-2505

Hospital & facility affiliations

  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150
  • Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025
  • Samaritan Pacific Community Hospital Hospital, Newport, OR, CCN 381314

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux64
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60946286WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Clinics LLC CurrentSince Aug 17, 2020 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Past Accepting new patients

Locations

25050 SE Stark St
Ste 265
Gresham, OR 97030
Phone (503) 413-2005

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

1130 NW 22nd Ave
Ste 500
Portland, OR 97210
Phone (503) 229-7339

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

475 S Columbia River Hwy
Ste 100
Saint Helens, OR 97051
Phone (503) 229-8455

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 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1114337466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 NW 22ND AVE STE 500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102976",
            "telephone_number": "503-413-5725",
            "fax_number": "503-413-5726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 NW 22ND AVE STE 500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102976",
            "telephone_number": "503-413-5725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Madison St",
            "address_2": "Ste 900",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981041347",
            "country_code": "US",
            "telephone_number": "206-215-6800",
            "fax_number": "206-215-6801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNOWLES",
        "first_name": "THOMAS",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-07",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD198666",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60946286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114337466",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.