Individual provider Active NPI

Matthew B Kingsbauer, D.O.

  • Family Medicine Physician
  • Eugene, OR
National Provider Identifier
1720039704
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO194141 Issued in OR
Practice address
360 S Garden Way Ste 105
Eugene, OR 97401-8173
Phone
(802) 773-3386
Fax
(802) 773-4578
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO194141 OR Primary

Addresses

Primary practice location

360 S Garden Way Ste 105
Eugene, OR 97401-8173

Mailing address

500 NE Multnomah St Ste 100
Portland, OR 97232-2031
Phone (504) 813-2000

Other identifiers 1

IdentifierTypeStateIssuer
1018489MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, 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

Enrollment IDStateProvider typePAC IDDetails
I20170531001543 HI Practitioner - Family Practice 3577531318 Reassigns benefits to 1 organization
I20191126000687 OR Practitioner - Family Practice 3577531318 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2001
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)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO194141ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Permanente Medical Group Inc CurrentSince May 1, 2017 Accepting new patients
Lane County Oregon CurrentSince Oct 1, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 4, 2025 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 4, 2025 Accepting new patients

Locations

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

55 Maui Lani Pkwy
Wailuku, HI 96793
Phone (808) 243-6000

10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880

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

1022 Green Acres Rd
Eugene, OR 97408
Phone (541) 682-3551

500 NE Multnomah St
Ste 100
Portland, OR 97232
Phone (503) 499-5200

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

2073 Olympic St
Springfield, OR 97477
Phone (541) 682-3530

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1720039704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322031",
            "telephone_number": "504-813-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 S GARDEN WAY STE 105",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018173",
            "telephone_number": "802-773-3386",
            "fax_number": "802-773-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGSBAUER",
        "first_name": "MATTHEW",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO194141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018489",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.