Individual provider Active NPI

Michael Joseph Kilbourne, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Portland, OR
National Provider Identifier
1235442682
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD196653 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-7820
Fax
(503) 494-7829
NPI assigned
Jul 14, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD196653 OR
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD61116993 WA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD196653 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

1400 SW 5TH Ave Ste 500
Portland, OR 97201-5537

Other practice location 1

200 NE Mother Joseph Pl Ste 320
Vancouver, WA 98664-3205
Phone (360) 514-6300

Other practice location 2

9040 Jackson Ave
Tacoma, WA 98431-3098
Phone (253) 968-3885

Other practice location 3

1061 Harmon Avenue
Fort Stewart, GA 31314-5674
Phone (912) 435-5516

Other practice location 4

4700 Waters Ave Ste 400
Savannah, GA 31404-6220
Phone (912) 273-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, OR, WA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20110127000459 GA Practitioner - General SurgeryPractitioner - Thoracic Surgery 2466631171 Reassigns benefits to 2 organizations
I20200717002494 OR Practitioner - Cardiac Surgery 2466631171 Reassigns benefits to 3 organizations
I20231005003862 WA Practitioner - Thoracic Surgery 2466631171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Surgery
Education
Uniformed Services Uhs Fe Hebert School of Med, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portland Adventist Medical CenterGroup PAC ID 3274908819, 273 clinicians
PeacehealthGroup PAC ID 8820178288, 245 clinicians
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

10000 SE Main St
Suite 365
Portland, OR 97216-2474
Phone (503) 261-4430

200 NE Mother Joseph PL
Suite 320
Vancouver, WA 98664-3205
Phone (360) 514-6300

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)18
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Adventist Medical Center CurrentSince Dec 1, 2020 Accepting new patients
Au Medical Associates Inc CurrentSince Feb 2, 2019 Accepting new patients
Portland Adventist Medical Center Surgery CurrentSince Jul 8, 2023 Accepting new patients
Peacehealth Surgery CurrentSince Sep 18, 2023 Accepting new patients
University Professional Services Current Accepting new patients
Portland Adventist Medical Center CurrentSince Dec 1, 2020 Accepting new patients
University Professional Services CurrentSince Aug 1, 2020 Accepting new patients
Au Medical Associates Inc CurrentSince Feb 2, 2019 Accepting new patients
Portland Adventist Medical Center CurrentSince Jul 8, 2023 Accepting new patients
MPPG, Inc. Surgery CurrentSince Dec 1, 2017 Accepting new patients
University Professional Services CurrentSince Aug 1, 2020 Accepting new patients
Oregon Health & Science University Past Accepting new patients
University Professional Services Past Accepting new patients

Locations

1230 Baxter St
Athens, GA 30606
Phone (706) 364-3100

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

4700 Waters Ave
Ste 400
Savannah, GA 31404
Phone (912) 273-1100

4731 Waters Ave
Savannah, GA 31404
Phone (912) 350-4905

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

10151 SE Sunnyside Rd
Ste 100
Clackamas, OR 97015
Phone (503) 659-0880

14450 SE Royer Rd
Damascus, OR 97089
Phone (503) 658-5521

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151

3181 SW Sam Jackson Park Rd
#L353
Portland, OR 97239
Phone (503) 494-4190

10123 SE Market St
Portland, OR 97216
Phone (503) 251-6355

10000 SE Main St
Ste 365
Portland, OR 97216
Phone (503) 261-4430

1400 SW 5th Ave
Ste 500
Portland, OR 97201

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

200 NE Mother Joseph Pl
Ste 320
Vancouver, WA 98664
Phone (360) 514-6300

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

Interoperability endpoints

  • Direct secure messaging: mkilbourne123626@direct.ohsu.edu

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1235442682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 SW 5TH AVE STE 500",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7820",
            "fax_number": "503-494-7829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 NE Mother Joseph Pl Ste 320",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986643205",
            "country_code": "US",
            "telephone_number": "360-514-6300",
            "fax_number": "360-514-6301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9040 Jackson Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984313098",
            "country_code": "US",
            "telephone_number": "253-968-3885",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1061 Harmon Avenue",
            "address_purpose": "LOCATION",
            "city": "Fort Stewart",
            "state": "GA",
            "postal_code": "313145674",
            "country_code": "US",
            "telephone_number": "912-435-5516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4700 Waters Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-273-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILBOURNE",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-14",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD196653",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WA",
            "license": "MD61116993",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OR",
            "license": "MD196653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.