Heidi Kjos, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD60200769 Issued in WA

Practice address

3101 SE 192ND Ave
Suite 106
Vancouver, WA 98683-1442

Phone

(360) 729-8010

Fax

(360) 729-8011

NPI assigned

Oct 3, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Family Practice

Education

University of Minnesota Medical School, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hkjos681630@direct.peacehealth.org

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.

• Peacehealth

  • Surgery Physician
  • Vancouver, WA
  • NPI 1609061969
  Medicare reassignment Care Compare group NPD
• Peacehealth

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999

  Family Medicine

  Medicare reassignment NPD
• Providence Health & Services - Oregon

  • Obstetrics & Gynecology Physician
  • Portland, OR
  • NPI 1154427821
  NPD
• Providence Health & Services Oregon

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  NPD

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

• Peacehealth

  • Cardiovascular Disease Physician
  • Vancouver, WA
  • NPI 1003194911

  Hospital

  Care Compare affiliation
• Peacehealth

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  Care Compare affiliation

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1124015433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SE 192ND AVE",
            "address_2": "SUITE 106",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986831442",
            "telephone_number": "360-729-8010",
            "fax_number": "360-729-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KJOS",
        "first_name": "HEIDI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-03",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD153026",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60200769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00946521",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500631081",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hkjos118270@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "3101 SE 192nd Ave",
            "address_2": "SUITE 106",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986831442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Natasha Kitchen
• Martine Kivatinetz
• Sonam Ravindra Kiwalkar, MD
• Kinai Kiyokawa, DMD
• Kristin J Kjensrud, P.T.
• KKW Massage, Inc
• Jane Klaasen, MSW
• Jennifer Marie Klamfoth, LMP
• Gia Klauss, DVM
• Carly Kleiber, CPO

• Family Medicine Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.