Individual provider Active NPI

Kinsley Anne Hubel, MB BCH BAO

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1366853814
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD206882 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd # 67
Portland, OR 97239-3098
Phone
(503) 494-7680
NPI assigned
May 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD19685 HI
Internal Medicine Physician 207R00000X A157479 CA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD206882 OR
Pulmonary Disease Physician 207RP1001X MD206882 OR
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X MD206882 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd # 67
Portland, OR 97239-3098

Mailing address

3181 SW Sam Jackson Park Rd # 67
Portland, OR 97239-3098
Phone (503) 494-7680

Other practice location 1

1 Jarrett White Rd
Tripler Army Medical Center
Tripler Army Medical Center, HI 96859
Phone (808) 433-4049

Other practice location 2

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 256-5130

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
I20210920003571 OR Practitioner - Internal Medicine 3678970506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
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)

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311

Hospital & facility affiliations

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 Medicine

State licenses

LicenseStateTypeSpecialty
A157479CAMDInternal Medicine Physician
MD19685HIMDInternal Medicine Physician
MD206882ORMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Sep 15, 2021 Accepting new patients
University Professional Services CurrentSince Sep 15, 2021 Accepting new patients

Locations

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

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

3181 SW Sam Jackson Park Rd
#67
Portland, OR 97239
Phone (503) 494-1620

Interoperability endpoints

  • Direct secure messaging: khubel135276@direct.ohsu.edu

Organizations & group practices 3

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": "1400284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1366853814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # 67",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098",
            "telephone_number": "503-494-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # 67",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393098",
            "telephone_number": "503-494-7680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Jarrett White Rd",
            "address_2": "Tripler Army Medical Center",
            "address_purpose": "LOCATION",
            "city": "Tripler Army Medical Center",
            "state": "HI",
            "postal_code": "96859",
            "country_code": "US",
            "telephone_number": "808-433-4049",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2823 Fresno St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937211324",
            "country_code": "US",
            "telephone_number": "559-256-5130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUBEL",
        "first_name": "KINSLEY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MB BCH BAO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-17",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD19685",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A157479",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OR",
            "license": "MD206882",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "MD206882",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD206882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.