NPIMap

Individual provider Active NPI

Kishore Gopinathan Pathial, MD

  • Pulmonary Disease Physician
  • McMinnville, OR
National Provider Identifier
1396765236
Registry record updated Aug 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
695279-1 Issued in OR
Practice address
2397 NE Cumulus Ave
McMinnville, OR 97128-6257
Phone
(503) 472-5163
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 695279-1 OR
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 695279-1 OR
Pulmonary Disease Physician 207RP1001X 695279-1 OR Primary

Addresses

Primary practice location

2397 NE Cumulus Ave
McMinnville, OR 97128-6257

Mailing address

2397 NE Cumulus Ave
McMinnville, OR 97128-6257
Phone (503) 472-5163

Other identifiers 1

IdentifierTypeStateIssuer
055884MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040712000075 OR Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Sleep Medicine 8224928395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine, Sleep Medicine
Education
Other, 1986
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2397 NE Cumulus Ave
McMinnville, OR 97128-8861
Phone (503) 472-5163

Hospital & facility affiliations

  • Willamette Valley Medical Center Hospital, McMinnville, OR, CCN 380071
  • Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037
  • Samaritan North Lincoln Hospital Hospital, Lincoln City, OR, CCN 381302
  • Samaritan Pacific Community Hospital Hospital, Newport, OR, CCN 381314
  • Adventist Health Tillamook Hospital, Tillamook, OR, CCN 381317

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as individual
Quality
56.2
Promoting interoperability
95
Improvement activities
40
Cost
85.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
695279-1ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kishore G. Pathial, M.D., P.C. Internal Medicine CurrentSince Jan 1, 2003 Accepting new patients

Locations

2397 NE Cumulus Ave
McMinnville, OR 97128
Phone (503) 472-5163

2397 NE Cumulus Ave
Slp Ctr
McMinnville, OR 97128
Phone (503) 472-5163

Interoperability endpoints

  • Direct secure messaging: kishore.pathial.1@5756.direct.athenahealth.com

Organizations & group practices 1

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 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1396765236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2397 NE CUMULUS AVE",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286257",
            "telephone_number": "503-472-5163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2397 NE CUMULUS AVE",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286257",
            "telephone_number": "503-472-5163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHIAL",
        "first_name": "KISHORE",
        "middle_name": "GOPINATHAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "695279-1",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OR",
            "license": "695279-1",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OR",
            "license": "695279-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055884",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

Verify at the official NPI Registry.