Individual provider Active NPI

Cyril Kuriakose, MD

  • Nephrology Physician
  • Tualatin, OR
National Provider Identifier
1255536181
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD209095 Issued in OR
Practice address
19300 SW 65TH Ave
Tualatin, OR 97062-7706
Phone
(503) 692-1212
NPI assigned
Jun 20, 2007
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD60279943 WA
Nephrology Physician 207RN0300X MD209095 OR Primary
Nephrology Physician 207RN0300X ME115421 FL
Nephrology Physician 207RN0300X MED-PHYS-COM-LIC-145 MT

Addresses

Primary practice location

19300 SW 65TH Ave
Tualatin, OR 97062-7706

Mailing address

1130 NW 22ND Ave Ste 640
Portland, OR 97210-5488
Phone (503) 229-7976

Other practice location 1

1130 NW 22nd Ave Ste 640
Portland, OR 97210-5488
Phone (503) 229-7976

Other practice location 2

1101 Jackson St SW
Gravette, AR 72736-9121
Phone (479) 787-5291

Other practice location 3

3055 N Reserve St Ste D
Missoula, MT 59808-1395
Phone (406) 327-7000

Other identifiers 2

IdentifierTypeStateIssuer
EINOtherFL591561574
1255536181MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, FL, OR, ND, MT, ID, NC, OK, AR9 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 9

Enrollment IDStateProvider typePAC IDDetails
I20120719000641 WA Practitioner - NephrologyPractitioner - Internal Medicine 2062683725 Reassigns benefits to 3 organizations
I20130605000369 FL Practitioner - Nephrology 2062683725 Reassigns benefits to 1 organization
I20230424000746 OR Practitioner - NephrologyPractitioner - Internal Medicine 2062683725 Reassigns benefits to 5 organizations
I20241113001519 ND Practitioner - Nephrology 2062683725 Reassigns benefits to 3 organizations
I20250108002865 MT Practitioner - Nephrology 2062683725 Reassigns benefits to 1 organization
I20250620000702 ID Practitioner - Nephrology 2062683725 Reassigns benefits to 2 organizations
I20250701004753 NC Practitioner - Nephrology 2062683725 Reassigns benefits to 1 organization
I20250917001081 OK Practitioner - Nephrology 2062683725 Reassigns benefits to 1 organization
I20260303003381 AR Practitioner - Internal MedicinePractitioner - Nephrology 2062683725 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Ubh of Oregon LLCGroup PAC ID 4981772639, 20 clinicians
Cooperstown Medical CenterGroup PAC ID 5698687689, 13 clinicians
Sgoh Acquisition IncGroup PAC ID 5092616276, 95 clinicians
Legacy Meridian Park HospitalGroup PAC ID 5092609842, 113 clinicians
RenasolveGroup PAC ID 2365923208, 7 clinicians
Centennial Medical Group IncGroup PAC ID 6103982962, 60 clinicians
Washington Kidney Care LLCGroup PAC ID 1456882836, 2 clinicians
Garfield County Memorial Hospital DistrictGroup PAC ID 2668360769, shared by 3 NPIs, 9 clinicians
McKenzie County Healthcare Systems IncGroup PAC ID 5890768006, shared by 5 NPIs, 63 clinicians

Practice addresses (Care Compare)

10300 SW Eastridge St
Portland, OR 97225-5004
Phone (503) 944-5000

107 13TH St N
New Rockford, ND 58356
Phone (701) 947-2042

1101 Jackson St SW
Gravette, AR 72736-9121
Phone (479) 787-5291

19300 SW 65TH Ave
Tualatin, OR 97062-7706
Phone (503) 413-4330

201 NW Medical Loop
Suite 170
Roseburg, OR 97471-8835
Phone (503) 998-4125

2460 NW Stewart Pkwy
Suite 102
Roseburg, OR 97471-1516
Phone (541) 464-6258

410 Birchwood Ave
Suite 200
Bellingham, WA 98225-1783
Phone (360) 554-2501

417 Fairview Ave
Ponca City, OK 74601-1923
Phone (580) 762-3770

446 Pataha St
Pomeroy, WA 99347-8634
Phone (509) 843-1591

709 4TH Ave NE
Watford City, ND 58854-7628
Phone (701) 842-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MED-PHYS-COM-LIC-145MTMDCardiovascular Disease Physician
MD60279943WAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Kidney Care LLC Nephrology CurrentSince Oct 1, 2024 Accepting new patients
Garfield County Memorial Hospital District CurrentSince Jul 13, 2025 Accepting new patients
Legacy Meridian Park Hospital CurrentSince Nov 25, 2024 Accepting new patients
Walter Knox Memorial Hospital Current Accepting new patients
Garfield County Memorial Hospital District Current Accepting new patients
Providence Health & Services Mt Current Accepting new patients
Legacy Meridian Park Hospital CurrentSince Nov 25, 2024 Accepting new patients
Providence Health & Services Mt CurrentSince Jan 13, 2025 Accepting new patients
Garfield County Memorial Hospital District CurrentSince Jul 13, 2025 Accepting new patients
Nephrology Associates of Central Florida, P.a. Nephrology CurrentSince Jul 15, 2013 Accepting new patients
McKenzie County Healthcare Systems Inc CurrentSince Sep 28, 2024 Accepting new patients
Stillwater Medical Center Authority CurrentSince Aug 1, 2025 Accepting new patients
Centennial Medical Group Inc. CurrentSince Jun 9, 2025 Accepting new patients
McKenzie County Healthcare Systems Inc CurrentSince Sep 28, 2024 Accepting new patients
Ubh of Oregon, LLC CurrentSince Aug 1, 2024 Accepting new patients
Stillwater Medical Center Authority CurrentSince Aug 1, 2025 Accepting new patients
Sgoh Acquisition Inc CurrentSince Jan 26, 2026 Accepting new patients
Sgoh Acquisition Inc CurrentSince Jan 26, 2026 Accepting new patients
Renasolve Nephrology CurrentSince Dec 17, 2025 Accepting new patients
Walter Knox Memorial Hospital CurrentSince Apr 7, 2025 Accepting new patients
Walter Knox Memorial Hospital CurrentSince Apr 7, 2025 Accepting new patients
Sampson Regional Hospitalists, LLC CurrentSince Jun 1, 2025 Accepting new patients
Cooperstown Medical Center CurrentSince Dec 5, 2024 Accepting new patients
Providence Health & Services Mt CurrentSince Jan 13, 2025 Accepting new patients
Cooperstown Medical Center CurrentSince Dec 5, 2024 Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
Renal Access of Central Florida LLC Nephrology Past Accepting new patients
Legacy Meridian Park Pediatric Rehab Past Accepting new patients

Locations

1101 Jackson St SW
Gravette, AR 72736
Phone (479) 787-5221

2501 N Orange Ave
Ste 537N
Orlando, FL 32804
Phone (407) 894-4693

807 S Orlando Ave
Ste C
Winter Park, FL 32789
Phone (407) 894-4693

1202 E Locust St
Emmett, ID 83617
Phone (208) 365-2338

3055 N Reserve St
Ste D
Missoula, MT 59808
Phone (406) 327-7000

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

607 Beaman St
Clinton, NC 28328
Phone (910) 590-8729

107 12th St S
Cooperstown, ND 58425
Phone (701) 786-1700

1200 Roberts Ave NE
Cooperstown, ND 58425
Phone (701) 797-2128

1002 18th Ave SE
Ste C
Minot, ND 58701
Phone (701) 857-6010

525 N Main St
Watford City, ND 58854
Phone (701) 842-3771

709 4th Ave NE
Watford City, ND 58854
Phone (701) 444-2331

1542 16th St W
Ste 300
Williston, ND 58801
Phone (701) 572-2470

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

10300 SW Eastridge St
Portland, OR 97225
Phone (503) 944-5000

201 NW Medical Loop
Ste 170
Roseburg, OR 97471
Phone (541) 440-2165

201 NW Medical Loop
Ste 190
Roseburg, OR 97471
Phone (541) 644-4319

2460 NW Stewart Pkwy
Ste 102
Roseburg, OR 97471
Phone (541) 464-6258

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

410 Birchwood Ave
Ste 200
Bellingham, WA 98225
Phone (360) 554-2501

446 Pataha St
Pomeroy, WA 99347
Phone (503) 843-1491

66 N 6th St
Pomeroy, WA 99347
Phone (509) 843-1491

Interoperability endpoints

  • Direct secure messaging: cyril.kuriakose.1@17388.direct.athenahealth.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/eb237299-e2be-4fd4-aca6-5fa7adcd28c1/
  • Direct secure messaging: washingtonkidneycare.cyrilkuriakose@160470.advancedmd-direct.com

Organizations & group practices 34

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 34

Hospital & facility affiliations 9

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": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1255536181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 NW 22ND AVE STE 640",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105488",
            "telephone_number": "503-229-7976",
            "fax_number": "503-274-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19300 SW 65TH AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627706",
            "telephone_number": "503-692-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1130 NW 22nd Ave Ste 640",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972105488",
            "country_code": "US",
            "telephone_number": "503-229-7976",
            "fax_number": "503-274-4867",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Jackson St SW",
            "address_purpose": "LOCATION",
            "city": "Gravette",
            "state": "AR",
            "postal_code": "727369121",
            "country_code": "US",
            "telephone_number": "479-787-5291",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3055 N Reserve St Ste D",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598081395",
            "country_code": "US",
            "telephone_number": "406-327-7000",
            "fax_number": "406-329-1927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KURIAKOSE",
        "first_name": "CYRIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-20",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD60279943",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OR",
            "license": "MD209095",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME115421",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MT",
            "license": "MED-PHYS-COM-LIC-145",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "591561574",
            "identifier": "EIN",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255536181",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

Sources for this page

Verify at the official NPI Registry.