Kevin Patrick Blaine, MD, MPH

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD195468 Issued in OR

Practice address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Phone

(503) 494-7641

Fax

(503) 494-4661

NPI assigned

May 16, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, OR2 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 2

Specialty

Anesthesiology

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sound Physicians Intensivists of Washington PLLCGroup PAC ID 5395018808, 81 clinicians

Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Hospitalist Medicine Physicians of Washington - TCSGroup PAC ID 6800240102, 197 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Portland Medical Center Hospital, Portland, OR, CCN 380061
• University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kblaine585424@direct.peacehealth.org
• Direct secure messaging: kpblaine@yourcarecommunity.org

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.

• Hospitalist Medicine Physicians of Washington - TCS

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1649816380
  Medicare reassignment Care Compare group NPD
• Sound Physicians Intensivists of Washington PLLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Spokane, WA
  • NPI 1528582699

  OR

  Medicare reassignment Care Compare group NPD
• Regents of the Univ of Ca

  • Maternal & Fetal Medicine Physician
  • Sacramento, CA
  • NPI 1013906973
  Medicare reassignment Care Compare group
• Peacehealth

  • Hospitalist Physician
  • Springfield, OR
  • NPI 1740223874
  Medicare reassignment NPD
• University Anesthesiology Associates, LLC

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1841217817
  Medicare reassignment NPD
• Peacehealth

  • General Acute Care Hospital
  • Springfield, OR
  • NPI 1083888515
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003991845
  Care Compare affiliation
• Providence Health & Services - Oregon

  • Case Manager/Care Coordinator
  • Portland, OR
  • NPI 1891822995

  Hospital

  Care Compare affiliation
• Regents of the University of California

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1710918545
  Care Compare affiliation

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1457644098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7641",
            "fax_number": "503-494-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7641",
            "fax_number": "503-494-4661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 SE 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971234246",
            "country_code": "US",
            "telephone_number": "503-681-1111",
            "fax_number": "503-681-4066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAINE",
        "first_name": "KEVIN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A117484",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "MD",
            "license": "D78083",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "CA",
            "license": "A117484",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD195468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose A Blackwell, MD
• Kristina M Blackwood
• Sally J. Blackwood, MA, LPC
• Anastasia Blagoveshchenskaya
• Jennifer Blain, CADC II
• Andromeda Desa Blair
• Anthony Ronald Blair, LPCA
• Jacob R Blair, MD
• Jeffrey Russell Blair Jr., DO
• Jennifer L Blair, QMHP

• Anesthesiology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Anesthesiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.