Active NPI
Keith Bertram Quencer, MD
- Vascular & Interventional Radiology Physician
- Portland, OR
National Provider Identifier
1760643290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular & Interventional Radiology Physician
- License
- MD206802
- Practice address
- 3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011 - Phone
- (503) 494-7660
- Fax
- (503) 494-4258
- NPI assigned
- Jun 18, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 102077 | MA | |
| Diagnostic Radiology Physician | 2085R0202X | MD206802 | OR | |
| Vascular & Interventional Radiology Physician | 2085R0204X | 053203 | CT | |
| Vascular & Interventional Radiology Physician | 2085R0204X | MD206802 | OR | Primary |
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) 494-7660
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kquencer248856@direct.med.utah.edu | Direct | UNIVERSITY OF UTAH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Radiology
- Education
- University of Florida College of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.11 of 100
- Quality
- 84.29
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Leg revascularization (restoring blood flow) | 1-10 |
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102077 | MA | MD | Clinical Social Worker |
| 140921 | CA | MD | Marriage & Family Therapist |
| 053203 | CT | MD | Vascular & Interventional Radiology Physician |
Practice roles
Locations
15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000
24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674
1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074
1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600
2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200
1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582
501 N Graham St
Ste 200
Portland, OR 97227
Phone (503) 413-4488
19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
Interoperability endpoints
- kquencer138148@direct.ohsu.edu
Organizations & group practices 17
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.
-
- General Practice Physician
- Portland, OR
- NPI 1376709535
-
- General Acute Care Hospital
- Portland, OR
- NPI 1831112358
-
- General Acute Care Hospital
- Portland, OR
- NPI 1780608216
-
- General Acute Care Hospital
- Tualatin, OR
- NPI 1184647620
-
- Clinic/Center
- Gresham, OR
- NPI 1386919132
-
- General Practice Physician
- Salt Lake City, UT
- NPI 1114321981
-
- Community/Retail Pharmacy
- Portland, OR
- NPI 1417977976
-
- Clinic/Center
- Portland, OR
- NPI 1700809027
-
- Community/Retail Pharmacy
- Portland, OR
- NPI 1609896174
-
- Clinic/Center
- Portland, OR
- NPI 1679597108
-
- Hospitalist Physician
- Tualatin, OR
- NPI 1023305034
-
- General Acute Care Hospital
- Gresham, OR
- NPI 1255354700
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Astoria, OR
- NPI 1134146939
-
- Critical Access Hospital
- Astoria, OR
- NPI 1700809761
-
- Critical Access Hospital Clinic/Center
- The Dalles, OR
- NPI 1306842752
-
- General Acute Care Hospital
- Portland, OR
- NPI 1609824010
-
- General Acute Care Hospital
- Salem, OR
- NPI 1265431829
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701302400000",
"number": "1760643290",
"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": "503-494-7660",
"fax_number": "503-494-4258"
},
{
"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": "503-494-7660",
"fax_number": "503-494-4258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUENCER",
"first_name": "KEITH",
"middle_name": "BERTRAM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-18",
"last_updated": "2023-11-30",
"certification_date": "2023-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "102077",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OR",
"license": "MD206802",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "CT",
"license": "053203",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "OR",
"license": "MD206802",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kquencer248856@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "UNIVERSITY OF UTAH",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.