Individual provider Active NPI

Karl Thomas Winston, PA

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1689791162
Registry record updated Mar 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01140 Issued in OR
Practice address
1015 NW 22ND Ave
Emergency Deparment Acu
Portland, OR 97210-3025
Phone
(503) 413-7711
NPI assigned
Mar 22, 2007
Last updated
Mar 19, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01140 OR Primary

Addresses

Primary practice location

1015 NW 22ND Ave
Emergency Deparment Acu
Portland, OR 97210-3025

Mailing address

2701 NW Vaughn St Ste 160
Kaiser Permanente Continuing Care Services
Portland, OR 97210-5344
Phone (503) 499-5608

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070601000269 OR Practitioner - Physician Assistant 8527166339 Reassigns benefits to 1 organization
I20210916001428 WA Practitioner - Physician Assistant 8527166339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10100 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

9800 SE Sunnyside Rd
Clackamas, OR 97015-9750
Phone (800) 813-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA01140ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince May 4, 2013 Accepting new patients
Manor Care of Salmon Creek Wa, Association CurrentSince Jun 2, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince May 4, 2013 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

2701 NW Vaughn St
Ste 160
Portland, OR 97210
Phone (503) 499-5200

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

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237420800000",
    "number": "1689791162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 NW VAUGHN ST STE 160",
            "address_2": "KAISER PERMANENTE CONTINUING CARE SERVICES",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105344",
            "telephone_number": "503-499-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 NW 22ND AVE",
            "address_2": "EMERGENCY DEPARMENT ACU",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103025",
            "telephone_number": "503-413-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINSTON",
        "first_name": "KARL",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2009-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.