NPIMap

Individual provider Active NPI

Laura L Kuipers, DO

  • Hospitalist Physician
  • Portland, OR
National Provider Identifier
1902097850
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
DO28258 Issued in OR
Practice address
4805 NE Glisan Street
Suite BG05
Portland, OR 97213-2933
Phone
(503) 215-2392
NPI assigned
Aug 6, 2007
Last updated
Mar 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO28258 OR
Hospitalist Physician 208M00000X DO28258 OR Primary

Addresses

Primary practice location

4805 NE Glisan Street
Suite BG05
Portland, OR 97213-2933

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other identifiers 2

IdentifierTypeStateIssuer
P00630537OtherORRR MEDICARE (PH&S)-PMG
247483MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lkuipers110056@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080729000400 OR Practitioner - HospitalistPractitioner - Internal Medicine 1052485737 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1001 N Providence Dr
Newberg, OR 97132-7485
Phone (503) 537-5612

1111 Crater Lake Ave
Medford, OR 97504-6241
Phone (541) 732-5545

725 S Wahanna Rd
Seaside, OR 97138-7735
Phone (503) 717-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO28258ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Internal Medicine CurrentSince Jul 15, 2014 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon Internal Medicine CurrentSince Jun 1, 2022 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jun 30, 2008 Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 15, 2014 Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 1, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 30, 2008 Accepting new patients
Providence Health & Services Oregon CurrentSince Jul 1, 2018 Accepting new patients

Locations

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

1001 N Providence Dr
Newberg, OR 97132
Phone (503) 216-1538

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

4805 NE Glisan St
Ste BG5
Portland, OR 97213
Phone (503) 215-2392

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

Interoperability endpoints

  • Direct secure messaging: lkuipers110056@oc.providencedirect.org

Organizations & group practices 10

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 7

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": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1902097850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN STREET",
            "address_2": "SUITE BG05",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUIPERS",
        "first_name": "LAURA",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO28258",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "DO28258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE (PH&S)-PMG",
            "identifier": "P00630537",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "247483",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lkuipers110056@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4805 NE GLISAN STREET",
            "address_2": "SUITE BG05",
            "city": "PORTLAND",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972132933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.