Individual provider Active NPI

Kelly Ann Portnoff, M.D.

  • Rheumatology Physician
  • Portland, OR
National Provider Identifier
1255422481
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD153938 Issued in OR
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

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111004000569 OR Practitioner - Rheumatology 8224002266 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
A067472CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
American Arthritis & Rheumatology Associates -Or LLC Rheumatology CurrentSince Sep 11, 2023 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

  • Direct secure messaging: kelly.portnoff.p12@direct.aara1.nextgenshare.com
  • Direct secure messaging: 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.

Hospital & facility affiliations 3

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": "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

Verify at the official NPI Registry.