Individual provider Active NPI

David C Koon, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Portland, OR
National Provider Identifier
1528043205
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD23367 Issued in OR
Practice address
1040 NW 22ND Ave
Suite 320
Portland, OR 97210-3057
Phone
(503) 413-6294
Fax
(503) 413-7780
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD23367 OR Primary

Addresses

Primary practice location

1040 NW 22ND Ave
Suite 320
Portland, OR 97210-3057

Mailing address

1040 NW 22ND Ave
Suite 320
Portland, OR 97210-3057
Phone (503) 413-6294

Other identifiers 1

IdentifierTypeStateIssuer
287563MedicaidOR

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
I20100904000017 OR Practitioner - Physical Medicine and Rehabilitation 5698899144 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Hahnemann University College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Good Samaritan Hospital and Medical CenterGroup PAC ID 0547179939, 190 clinicians
Legacy Meridian Park HospitalGroup PAC ID 5092609842, 113 clinicians

Practice addresses (Care Compare)

1040 NW 22ND Ave
Suite 520
Portland, OR 97210-3097
Phone (503) 413-7557

19260 SW 65TH Ave
Suite 165
Tualatin, OR 97062-5706
Phone (503) 413-6550

Hospital & facility affiliations

  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025
  • Legacy Good Samaritan Hosp & Med Ctr Inpatient rehabilitation facility, Portland, OR, CCN 38T017

Merit-based Incentive Payment System (MIPS)

Final score
92.34 of 100Reported as group
Quality
92.55
Promoting interoperability
100
Improvement activities
40
Cost
76.53

Merit-based Incentive Payment System (MIPS)

Final score
94.62 of 100Reported as apm
Quality
77.21
Promoting interoperability
99.06
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Apr 6, 2024 Accepting new patients
Legacy Meridian Park Hospital CurrentSince Apr 6, 2024 Accepting new patients
Rehabilitation Medicine Associates, PC CurrentSince Aug 30, 2001 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
Legacy Meridian Park Hospital CurrentSince Apr 6, 2024 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Apr 6, 2024 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Past Accepting new patients

Locations

1040 NW 22nd Ave
Ste 320
Portland, OR 97210
Phone (503) 413-6294

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

1040 NW 22nd Ave
Ste 520
Portland, OR 97210
Phone (503) 413-7557

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

19260 SW 65th Ave
Ste 165
Tualatin, OR 97062
Phone (503) 413-6534

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

19250 SW 65th Ave
Ste 250
Tualatin, OR 97062
Phone (503) 692-4820

Interoperability endpoints

  • Direct secure messaging: dkoon11633@direct.lhs.org

Organizations & group practices 8

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 6

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1528043205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE",
            "address_2": "SUITE 320",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103057",
            "telephone_number": "503-413-6294",
            "fax_number": "503-413-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE",
            "address_2": "SUITE 320",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103057",
            "telephone_number": "503-413-6294",
            "fax_number": "503-413-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOON",
        "first_name": "DAVID",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OR",
            "license": "MD23367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287563",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.