NPIMap

Organization Active NPI

Kaiser Foundation Health Plan

Doing business as Central Interstate Medical Office

  • Multi-Specialty Clinic/Center
  • Portland, OR
National Provider Identifier
1285960732
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
KAISER FOUNDATION HEALTH PLAN
Doing business as
Central Interstate Medical Office
Practice address
3600 N Interstate Ave
Portland, OR 97227-1106
Phone
(503) 528-7458
NPI assigned
Oct 19, 2009
Organization subpart
Yes
Parent organization
KAISER FOUNDATION HEALTH PLANAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Authorized official

Name
Stephen Shawn Barton
Title
Executive Director, Revenue Cycle
Phone
(503) 813-2440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

3600 N Interstate Ave
Portland, OR 97227-1106

Mailing address

500 NE Multnomah St
Portland, OR 97232-2023
Phone (503) 813-4939

Other identifiers 1

IdentifierTypeStateIssuer
119040OtherORMAM CERTIFICATION

Other names 1

  • Central Interstate Medical Office Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Permanent150 organizations share this tax ID, including this one
Part of
Kaiser Permanent

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1255910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1285960732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322023",
            "telephone_number": "503-813-4939",
            "fax_number": "503-813-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 N INTERSTATE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271106",
            "telephone_number": "503-528-7458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KAISER FOUNDATION HEALTH PLAN",
        "enumeration_date": "2009-10-19",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "BARTON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, REVENUE CYCLE",
        "authorized_official_telephone_number": "503-813-2440"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAM CERTIFICATION",
            "identifier": "119040",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3600 N Interstate Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972271106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Central Interstate Medical Office",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Central Interstate Medical Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.