Individual provider Active NPI

Jeremiah Ben Knapp, M.D.

  • Family Medicine Physician
  • Tigard, OR
National Provider Identifier
1922414721
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD218059 Issued in OR
Practice address
12180 SW Scholls Ferry Rd
Tigard, OR 97223-3334
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Jul 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD218059 OR Primary
Family Medicine Physician 207Q00000X MD-21779 HI
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

12180 SW Scholls Ferry Rd
Tigard, OR 97223-3334

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other practice location 1

10803 SE Cherry Blossom Drive
Portland, OR 97216-3107
Phone (503) 261-7200

Other identifiers 2

IdentifierTypeStateIssuer
500833592MedicaidOR
MD218059OtherOROREGON MEDICAL BOARD LICENSE

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
I20210524002741 HI Practitioner - Family Practice 9133414717 Reassigns benefits to 3 organizations
I20240626003964 OR Practitioner - Family Practice 9133414717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oregon Health Sciences University School of Medicine, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10803 SE Cherry Blossom Dr
Portland, OR 97216-3107

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-21779HIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Queens University Medical Group CurrentSince Apr 22, 2022 Accepting new patients
The Queen'S Medical Center CurrentSince Jun 1, 2021 Accepting new patients
The Queen'S Medical Center Current Accepting new patients
Valeria Health, LLC CurrentSince May 26, 2024 Accepting new patients
The Queen'S Medical Center Current Accepting new patients
The Queens Medical Center CurrentSince Jun 1, 2021 Accepting new patients
Queen'S Development Corporation & Subsidiaries CurrentSince Jun 1, 2021 Accepting new patients
Queen'S Development Corporation & Subsidiaries CurrentSince Jun 1, 2021 Accepting new patients

Locations

1380 Lusitana St
Ste 804
Honolulu, HI 96813
Phone (808) 524-3020

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

377 Keahole St
Honolulu, HI 96825
Phone (808) 395-4427

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

10803 SE Cherry Blossom Dr
Portland, OR 97216
Phone (503) 261-7210

Interoperability endpoints

  • Direct secure messaging: jeremiah.knapp@hawaiihie.medicity.net

Organizations & group practices 9

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": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1922414721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12180 SW SCHOLLS FERRY RD",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972233334",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10803 SE Cherry Blossom Drive",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972163107",
            "country_code": "US",
            "telephone_number": "503-261-7200",
            "fax_number": "503-261-7249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNAPP",
        "first_name": "JEREMIAH",
        "middle_name": "BEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-01",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD218059",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD-21779",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500833592",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON MEDICAL BOARD LICENSE",
            "identifier": "MD218059",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.