Kenneth Charles Dirk, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD20699 Issued in OR

Practice address

9205 SW Barnes Rd
Portland, OR 97225-6603

Phone

(503) 297-6334

Fax

(503) 297-2360

NPI assigned

Oct 5, 2006

Last updated

Sep 19, 2023By the provider in NPPES

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

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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 1

Merit-based Incentive Payment System (MIPS)

Final score

88.71 of 100Reported as group

Quality

71.18

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

95.65 of 100Reported as group

Quality

98.12

Promoting interoperability

100

Improvement activities

40

Cost

80.38

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdirk101740@oc.providencedirect.org

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.

• Harney District Hospital

  • Critical Access Hospital
  • Burns, OR
  • NPI 1285742338
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  dba Providence St Vincent Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971

  Emergency Medicine

  Medicare reassignment NPD
• Western Healthcare Services Texas

  • Emergency Medicine Physician
  • Gold Beach, OR
  • NPI 1336878024
  Medicare reassignment NPD
• Harney District Hospital

  dba Harney District Hospital Family Care

  • Rural Health Clinic/Center
  • Burns, OR
  • NPI 1013276195
  NPD
• Harney District Hospital

  dba NewSun Energy & Harney District Hospital Specialty Care

  • Multi-Specialty Clinic/Center
  • Burns, OR
  • NPI 1972113306
  NPD
• Providence Health & Services - Oregon

  dba Prov St. Vincent Medical Ctr

  • Clinical Pathology Physician
  • Portland, OR
  • NPI 1831641745

  Emergency Medicine

  NPD

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1780770776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9340 SW BARNES RD",
            "address_2": "SUITE 202",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256623",
            "telephone_number": "503-297-6334",
            "fax_number": "503-297-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 SW BARNES RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256603",
            "telephone_number": "503-297-6334",
            "fax_number": "503-297-2360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "557 W Washington St",
            "address_purpose": "LOCATION",
            "city": "Burns",
            "state": "OR",
            "postal_code": "977201441",
            "country_code": "US",
            "telephone_number": "541-573-7281",
            "fax_number": "541-573-8627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIRK",
        "first_name": "KENNETH",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD20699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "930081411",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134004",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdirk101740@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9340 SW Barnes Rd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary Diorio, MSW, LCSW
• Brandi Maxine Dipasquale, MACOM, LAC
• Christopher Dirda, PA-C
• Anthony J Dire, MD
• Direct Nursing Services LLC
• Jennifer Lynn Dirkes, CRNA
• Ruth Dirks, LPC
• Tonja Cross Dirkx, MD
• Lindsay Anne Putnam Dirringer, DPT
• Hannah Rose Dischinger, MD

• Emergency Medicine Physician in Portland, OR
• Providers in Portland, 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 Sep 19, 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.