Individual provider Active NPI

Kishor Khanal, MD

  • Interventional Cardiology Physician
  • Portland, OR
National Provider Identifier
1962909952
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD225793 Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-7646
NPI assigned
Apr 7, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD225793 OR
Interventional Cardiology Physician 207RI0011X R80746 AZ
Internal Medicine Physician 207R00000X MD225793 OR
Cardiovascular Disease Physician 207RC0000X ME0146781 FL
Interventional Cardiology Physician 207RI0011X MD225793 OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Mailing address

3181 SW Sam Jackson Park Rd # Uhn62
Portland, OR 97239-3011
Phone (503) 494-1775

Other practice location 1

2501 N Orange Ave Ste 235
Orlando, FL 32804-4659
Phone (407) 303-5990

Other practice location 2

703 N Flamingo Rd
Pembroke Pines, FL 33028-1006
Phone (954) 844-4461

Other practice location 3

3838 N Campbell Ave Ste C
Tucson, AZ 85719-1454
Phone (520) 626-1232

Other practice location 4

3601 S 6th Ave
Tucson, AZ 85723-1006
Phone (520) 626-1232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250702001622 OR Practitioner - Cardiovascular Disease (Cardiology) 9133477664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1102 E 36TH St
Unit 4324
Tucson, AZ 85713-4967

1400 SW 5TH Ave
FL 5
Portland, OR 97201-5509

Hospital & facility affiliations

  • Peacehealth St John Medical Center Hospital, Longview, WA, CCN 500041
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0146781FLMDCardiovascular Disease Physician
R80746AZMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jun 16, 2025 Accepting new patients
University Professional Services CurrentSince Jun 16, 2025 Accepting new patients
University Professional Services Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

3181 SW Sam Jackson Park Rd
#62
Portland, OR 97239
Phone (503) 494-1775

Interoperability endpoints

  • Direct secure messaging: kkhanal197440@direct.ohsu.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1523059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1962909952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD # UHN62",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-1775"
        },
        {
            "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": "503-494-7646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 N Orange Ave Ste 235",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328044659",
            "country_code": "US",
            "telephone_number": "407-303-5990",
            "fax_number": "407-303-7323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "703 N Flamingo Rd",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281006",
            "country_code": "US",
            "telephone_number": "954-844-4461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3838 N Campbell Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857191454",
            "country_code": "US",
            "telephone_number": "520-626-1232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 S 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857231006",
            "country_code": "US",
            "telephone_number": "520-626-1232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHANAL",
        "first_name": "KISHOR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-07",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD225793",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AZ",
            "license": "R80746",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD225793",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME0146781",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OR",
            "license": "MD225793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.