NPIMap

Organization Active NPI

Kaiser Foundation Health Plan of the Northwest

  • Community Based Hospice Care Agency
  • Portland, OR
National Provider Identifier
1992860993
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Practice address
500 NE Multnomah St
Portland, OR 97232-2023
Phone
(503) 499-5200
Fax
(503) 499-5212
NPI assigned
Dec 27, 2006
Organization subpart
Yes
Parent organization
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWESTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Authorized official

Name
Mr. John D Kendrick
Title
Dir, SRVS Area Cont of Care
Phone
(360) 801-9655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

500 NE Multnomah St
Portland, OR 97232-2023

Mailing address

500 NE Multnomah St
Portland, OR 97232-2023
Phone (503) 813-4939

Other identifiers 2

IdentifierTypeStateIssuer
500674360MedicaidOR
2038439MedicaidWA

Other names 1

  • Kaiser Permanente Continuing Care Services Hospice Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081111000488 OR Part A Provider - Hospice 5799688230 Practice locations: Portland, OR

Hospice certification: CCN 381502

Legal name
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Doing business as
KAISER PERMANENTE CONTINUING CARE SERVICES HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 22, 1984
Last certification
Nov 20, 2019
Ownership / control type
Non-Profit - Other
Organization structure
CorporationNon-profit
Incorporated
Oct 19, 1981 in OR
Enrollment address
500 NE Multnomah St
Portland, OR 97232-2099

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Kaiser Permanente Continuing Care Services HospiceCCN 381502
Ownership
For-Profit
Certified
Oct 22, 1984
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Foundation185 organizations share this tax ID, including this one
Part of
Permananet Clinic

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
David J Barger Individual Corporate DirectorBoard Member May 1, 2017 100%
Margaret E Porfido Individual Corporate DirectorBoard Member Nov 1, 2011 100%
John Kendrick Individual Corporate OfficerAdministrator Jul 26, 2021
W-2 Managing EmployeeAdministrator Jul 26, 2021
Operational/Managerial ControlAdministrator Jul 26, 2021
Jenny Ming Individual Corporate DirectorBoard Member Jul 6, 2021
Richard P Shannon Individual Corporate DirectorBoard Member Jul 1, 2014 100%
Regina M Benjamin Individual Corporate DirectorBoard Member Jun 1, 2015 100%
Judith a Johansen Individual Corporate DirectorBoard Member Apr 1, 2006 100%
Douglas a Lemieux Individual W-2 Managing EmployeeSr Director Jul 8, 2018
David F Hoffmeister Individual Corporate DirectorBoard Member Nov 1, 2014 100%
Kaiser Foundation Hospitals Organization, Oakland, CA Corporation, Non-profit Operational/Managerial Control Jan 1, 1978 100%
Arnold Eugene Washington Individual Corporate DirectorBoard Member Jan 4, 2016 100%
Ines Gaeta Individual Operational/Managerial ControlController & Executive Director Apr 4, 2022
Jeffrey a Collins Individual Corporate OfficerRegional President, Northwest Aug 25, 2020
Jeffrey E Epstein Individual Corporate DirectorBoard Member Apr 1, 2013 100%
Ramon F Baez Individual Corporate DirectorBoard Member Jun 4, 2016 100%
Gregory a Adams Individual Corporate OfficerChairman & Ceo Nov 11, 2019 100%
Corporate DirectorChairman & Ceo Nov 11, 2019 100%
Matthew T Ryan Individual Corporate DirectorBoard Member Jan 1, 2020 100%
Leslie S Heisz Individual Corporate DirectorBoard Member Jan 1, 2015 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 78

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 78

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649721600000",
    "number": "1992860993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322023",
            "telephone_number": "503-813-4939",
            "fax_number": "503-813-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322023",
            "telephone_number": "503-499-5200",
            "fax_number": "503-499-5212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST",
        "enumeration_date": "2006-12-27",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "KENDRICK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIR, SRVS AREA CONT OF CARE",
        "authorized_official_telephone_number": "360-801-9655",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500674360",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2038439",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2701 NW Vaughn St",
            "address_2": "Suite 140",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972105311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "500 NE Multnomah St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972322023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kaiser Permanente Continuing Care Services Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaiser Permanente Continuing Care Services Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.