Robert L. Klobucnik, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD22292 Issued in OR

Practice address

19300 SW 65TH Ave
Tualatin, OR 97062-7706

Phone

(503) 692-7474

NPI assigned

Jul 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OR, WA2 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

Emergency Medicine

Education

Medical College of Ohio, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.85 of 100Reported as group

Quality

84.92

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  Emergency Medicine, WA

  Medicare reassignment Care Compare group NPD
• Legacy Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216
  Medicare reassignment NPD
• Northwest Acute Care Specialists PC

  • Emergency Medicine Physician
  • Portland, OR
  • NPI 1215983200

  WA

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1649722034
  NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1871848457

  Emergency Medicine

  NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD
• Legacy Good Samaritan Hospital and Medical Center

  • Community/Retail Pharmacy
  • Portland, OR
  • NPI 1609896174
  NPD
• Northwest Acute Care Specialists PC

  • Emergency Medicine Physician
  • Vancouver, WA
  • NPI 1487811048
  NPD
• Salem Emergency Physicians Service, PC

  • Emergency Medicine Physician
  • Salem, OR
  • NPI 1063454395
  NPD (past)
• Samaritan Emergency Corp

  • Emergency Medicine Physician
  • Dayton, OH
  • NPI 1922084136
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1609899012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6312 SW CAPITOL HWY",
            "address_2": "#502",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972391938",
            "telephone_number": "503-464-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19300 SW 65TH AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627706",
            "telephone_number": "503-692-7474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3550 N Interstate Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271196",
            "country_code": "US",
            "telephone_number": "503-652-2888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLOBUCNIK",
        "first_name": "ROBERT",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD22292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "CareEquality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3550 N Interstate Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972271196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "CareEquality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3550 N Interstate Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972271196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kkrueger Corporation
• Paul A Klas, M.D.
• Kleiman Healthcare Services
• Lindsay Kate Kleps, FNP
• Nadezda Klineva, COTA
• Dorothy Nell Knapp, PH.D.
• Lori Knapp
• Susan C Knight-Allen, LCSW
• Zachary James Knight, PA-C
• Irene Ko, RDH

• Emergency Medicine Physician in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.