Individual provider Active NPI

Keith Phillip Cross, M.D.

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Portland, OR
National Provider Identifier
1528105194
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
MD214291 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-7551
Fax
(503) 494-4997
NPI assigned
Jan 31, 2007
Last updated
Mar 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 294757-1 NY
Pediatrics Physician 208000000X MD214291 OR
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 40990 KY
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 294757-1 NY
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X MD214291 OR Primary
Internal Medicine Physician 207R00000X MD214291 OR
Pediatrics Physician 208000000X 40990 KY
Internal Medicine Physician 207R00000X 40990 KY
Internal Medicine Physician 207R00000X 294757-1 NY

Addresses

Primary practice location

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

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-7551

Other identifiers 3

IdentifierTypeStateIssuer
200882960MedicaidIN
7100025500MedicaidKY
03822786MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, NY, OR3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20071127000739 KY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3375632409 Reassigns benefits to 1 organization
I20190702000769 NY Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 3375632409 Reassigns benefits to 1 organization
I20230302003051 OR Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 3375632409 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

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
294757-1NYMDInternal Medicine Physician
40990KYMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Mar 1, 2023 Accepting new patients
Northwest Acute Care Specialists PC CurrentSince May 15, 2023 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Sep 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. Internal Medicine CurrentSince Sep 1, 2012 Accepting new patients
University Professional Services Current Accepting new patients
Northwest Acute Care Specialists PC CurrentSince May 15, 2023 Accepting new patients
University Professional Services CurrentSince Mar 1, 2023 Accepting new patients
University at Buffalo Pediatric Associates Inc Pediatrics CurrentSince May 4, 2019 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

571 S Floyd St
Ste 100
Louisville, KY 40202
Phone (502) 852-5331

1001 Main St
Fl 4
Buffalo, NY 14203
Phone (716) 636-8284

1001 Main St
Fl 5
Buffalo, NY 14203
Phone (716) 323-0031

1404 Sweet Home Rd
Buffalo, NY 14228
Phone (716) 932-6060

1404 Sweet Home Rd
Ste 56
Buffalo, NY 14228
Phone (716) 639-9361

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

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

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

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

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

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

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Interoperability endpoints

  • Direct secure messaging: kcross159181@direct.ohsu.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1528105194",
    "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": "503-494-7551",
            "fax_number": "503-494-4997"
        },
        {
            "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": "503-494-7551",
            "fax_number": "503-494-4997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSS",
        "first_name": "KEITH",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "294757-1",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD214291",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "KY",
            "license": "40990",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "294757-1",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "OR",
            "license": "MD214291",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD214291",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "40990",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "40990",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "294757-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200882960",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100025500",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03822786",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.