NPIMap

Individual provider Active NPI

David Kirakossian, M.D.

  • Rheumatology Physician
  • Portland, OR
National Provider Identifier
1215399308
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD209272 Issued in OR
Practice address
9555 SW Barnes Rd Ste 150
Portland, OR 97225-6691
Phone
(503) 297-3384
Fax
(503) 297-0863
NPI assigned
Mar 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A150426 CA
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X A150426 CA
Rheumatology Physician 207RR0500X MD209272 OR Primary

Addresses

Primary practice location

9555 SW Barnes Rd Ste 150
Portland, OR 97225-6691

Mailing address

9555 SW Barnes Rd Ste 150
Portland, OR 97225-6691
Phone (503) 297-3384

Other practice location 1

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098
Phone (503) 494-8211

Other practice location 2

710 Lawrence Expy
Santa Clara, CA 95051-5173
Phone (408) 851-3830

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
I20220801000347 OR Practitioner - Rheumatology 3577825637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
University of Pittsburgh School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwest Rheumatology Associates, PCGroup PAC ID 7214822899, 6 clinicians

Practice addresses (Care Compare)

9555 SW Barnes Rd
Suite 150
Portland, OR 97225-6691
Phone (503) 297-3384

Hospital & facility affiliations

  • Columbia Memorial Hospital Hospital, Astoria, OR, CCN 381320
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Providence Seaside Hospital Hospital, Seaside, OR, CCN 381303
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004
  • Hillsboro Medical Center Hospital, Hillsboro, OR, CCN 380021

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD209272ORMDRheumatology Physician
A150426CAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Rheumatology Associates, PC CurrentSince Aug 1, 2022 Accepting new patients

Locations

9555 SW Barnes Rd
Ste 150
Portland, OR 97225
Phone (503) 297-3384

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AHBHDD

Organizations & group practices 1

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1215399308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9555 SW BARNES RD STE 150",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256691",
            "telephone_number": "503-297-3384",
            "fax_number": "503-297-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 SW BARNES RD STE 150",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256691",
            "telephone_number": "503-297-3384",
            "fax_number": "503-297-0863"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393098",
            "country_code": "US",
            "telephone_number": "503-494-8211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "710 Lawrence Expy",
            "address_purpose": "LOCATION",
            "city": "Santa Clara",
            "state": "CA",
            "postal_code": "950515173",
            "country_code": "US",
            "telephone_number": "408-851-3830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRAKOSSIAN",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-28",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A150426",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "A150426",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OR",
            "license": "MD209272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.