Individual provider Active NPI

Kevin Duff, PHD

  • Clinical Neuropsychologist
  • Portland, OR
National Provider Identifier
1295720969
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
3589 Issued in OR
Practice address
3303 S Bond Ave
Portland, OR 97239-4501
Phone
(503) 494-7772
Fax
(503) 418-3283
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 00973 IA
Clinical Neuropsychologist 103G00000X 7381301-2501 UT
Psychologist 103T00000X 00973 IA
Clinical Neuropsychologist 103G00000X 3589 OR Primary

Addresses

Primary practice location

3303 S Bond Ave
Portland, OR 97239-4501

Mailing address

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-7772

Other identifiers 1

IdentifierTypeStateIssuer
37712OtherIAWELLMARK BCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kduff53177@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091023000387 UT Practitioner - Clinical Psychologist 0143278457 Reassigns benefits to 2 organizations
I20220914003826 OR Practitioner - Clinical Psychologist 0143278457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Professional ServicesGroup PAC ID 4880760107, 1,683 clinicians

Practice addresses (Care Compare)

3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8311

Hospital & facility affiliations

  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00973IAMDClinical Neuropsychologist
7381301-2501UTMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Behavioral Health Services CurrentSince Apr 1, 2015 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Sep 1, 2022 Accepting new patients
University of Utah Behavioral Health Services CurrentSince Apr 1, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University Professional Services CurrentSince Sep 1, 2022 Accepting new patients
University of Utah Behavioral Health Services Current Accepting new patients

Locations

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

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

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: kduff146970@direct.ohsu.edu

Organizations & group practices 9

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 1

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": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1295720969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-7772",
            "fax_number": "503-418-3283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 S BOND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394501",
            "telephone_number": "503-494-7772",
            "fax_number": "503-418-3283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFF",
        "first_name": "KEVIN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IA",
            "license": "00973",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "UT",
            "license": "7381301-2501",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IA",
            "license": "00973",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OR",
            "license": "3589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "37712",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kduff53177@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.