Active NPI
Kelly Ann Portnoff, M.D.
- Rheumatology Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- MD153938
- Practice address
- 800 SW 13TH Ave
Portland, OR 97205-1902 - Phone
- (503) 221-0161
- Fax
- (503) 274-1697
- NPI assigned
- Sep 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | A067472 | CA | |
| Rheumatology Physician | 207RR0500X | MD153938 | OR | Primary |
Addresses
Primary practice location
800 SW 13TH Ave
Portland, OR 97205-1902
Mailing address
800 SW 13TH Ave
Portland, OR 97205-1902
Phone (503) 221-0161
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kportnoff1720@direct.theportlandclinic.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Rheumatology
- Education
- Northeastern Ohio University College of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1585 SW Marlow Ave
Portland, OR 97225-5176
Phone (971) 384-5722
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A067472 | CA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Arthritis & Rheumatology Associates -Or LLC | Rheumatology | Current | Accepting new patients |
| Scripps Clinic Medical Group | Past | Accepting new patients |
Locations
1585 SW Marlow Ave
Ste 220
Portland, OR 97225
Phone (503) 729-6662
1585 SW Marlow Ave
Portland, OR 97225
Phone (503) 297-1444
Interoperability endpoints
- kelly.portnoff.p12@direct.aara1.nextgenshare.com
- kportnoff1720@direct.theportlandclinic.net
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.
-
- Rheumatology Physician
- Portland, OR
- NPI 1467235952
-
- Multi-Specialty Clinic/Center
- San Diego, CA
- NPI 1124003280
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Providence Portland Medical Center
- General Acute Care Hospital
- Portland, OR
- NPI 1003991845
-
dba Providence St Vincent Medical Center
- General Acute Care Hospital
- Portland, OR
- NPI 1114015971
-
- Case Manager/Care Coordinator
- Portland, OR
- NPI 1891822995
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1255422481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 SW 13TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051902",
"telephone_number": "503-221-0161",
"fax_number": "503-274-1697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 SW 13TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051902",
"telephone_number": "503-221-0161",
"fax_number": "503-274-1697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTNOFF",
"first_name": "KELLY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-26",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "A067472",
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "OR",
"license": "MD153938",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kportnoff1720@direct.theportlandclinic.net",
"affiliation": "N",
"address_1": "800 SW 13th Ave",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972051902",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.