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PHILLIP K KIYASU MD
NPI 1124010673
Internal Medicine - Gastroenterology in Portland, OR

Active since August 19, 2005PECOS Enrolled
1111 NE 99TH AVE, SUITE 301, PORTLAND, OR 97220(503) 963-2707(503) 963-2802 Get Directions Write a Review

NPPES record last updated: November 4, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 4, 2024, Dec 5, 2023, Nov 15, 2021 (3 updates tracked since 2021).

About Phillip K Kiyasu Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHILLIP K KIYASU MD (NPI 1124010673) is an individual gastroenterology provider in Portland, Oregon, licensed in Oregon (MD18844) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS and maintains a secondary practice location in Clackamas.

NPPES Registry Identity

NPI1124010673
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NamePHILLIP K KIYASUCredential: MD
Location Address1111 NE 99TH AVE, SUITE 301Portland, OR 97220-9428
Mailing Address541 Ne 20th Ave Ste 225Portland, OR 97232-2895 · (503) 963-2801 · Fax (503) 963-2825
Phone(503) 963-2707
Fax(503) 963-2802
Sole ProprietorNo
Enumeration DateAugust 19, 2005
Last NPPES UpdateNovember 4, 20243 updates tracked since enumeration
NPPES CertifiedNovember 4, 2024
✔ NPI 1124010673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses✔ Licensed in OR · MD18844✔ Licensed in WA · MD60293921
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
1111 NE 99TH AVE, Portland, OR 97220
Open in Google Maps ↗

Secondary Practice Location 1

Location 19300 SE 91st Ave Ste 300Clackamas, OR 97086-3762 · Phone (503) 963-2707 · Fax (503) 963-2802

Other Identifiers 2

Medicaid065607OR
Medicaid8206922WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Phillip K Kiyasu Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Phillip Kiyasu reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

The Oregon Clinic PC
4.0 mi
Specialist
541 NE 20TH AVE, SUITE 225
Portland, OR 97232
  • Reassigned Medicare billing, Oregon enrollment
  • 338 clinicians in this Medicare group
NPI 1265417174 (503) 963-2801

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, vedolizumab, intravenous, 1 mg J3380
Vedolizumab is a medication given via injection. It's used to treat certain bowel conditions (such as Crohn's disease, ulcerative colitis) by reducing inflammation. It works by blocking a certain protein that causes this inflammation.
4,803 services16 patients
Pathology examination of tissue using a microscope, intermediate complexity 88305
A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
91 services63 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
39 services39 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
30 services26 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
29 services27 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
28 services28 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97220 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.16 typical visit price
range $58.99 – $176.88
Typical copayment $33.54 (range $14.74 – $44.22)
Most-billed visit code 99204
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LOUIS SAMUELS LIBBY MD
Internal Medicine (Pulmonary Disease)
1111 NE 99TH AVE, SUITE 200
PORTLAND, OR 97220
Multnomah County (503) 963-3030
DOUGLAS CRAIG WALTA MD
Internal Medicine (Gastroenterology)
1111 NE 99TH AVE, SUITE 301
PORTLAND, OR 97220
Multnomah County (503) 963-2707
ALYSSA MARIE O'BRIEN RD
Dietitian, Registered
1111 NE 99TH AVE
PORTLAND, OR 97220
Multnomah County (503) 963-2707
JERZY O GIEDWOYN MD
Internal Medicine (Cardiovascular Disease)
1111 NE 99TH AVE, SUITE 201
PORTLAND, OR 97220
Multnomah County (503) 962-1000
DR. AMY LI RONG ZHU MD
Internal Medicine (Gastroenterology)
1111 NE 99TH AVE
PORTLAND, OR 97220
Multnomah County (503) 963-2707
MISS JACKIE MARCELLA WOLF PT
Physical Therapist
1111 NE 99TH AVE
PORTLAND, OR 97220
Multnomah County (503) 216-5410
STEPHEN JOHN YERMAL
Nurse Anesthetist, Certified Registered
1111 NE 99TH AVE, SUITE 302
PORTLAND, OR 97220
Multnomah County (503) 963-2763
THE OREGON CLINIC PC
Clinic/Center (Endoscopy)
1111 NE 99TH AVE
PORTLAND, OR 97220
Multnomah County (503) 963-2801

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phillip Kiyasu's NPI number?

The NPI number for Phillip Kiyasu is 1124010673. It was assigned to this individual provider in the NPPES registry on August 19, 2005.

Where is Phillip Kiyasu located?

Phillip Kiyasu practices at 1111 NE 99th Ave Suite 301, Portland, OR 97220. The listed phone number is (503) 963-2707.

What is Phillip Kiyasu's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Phillip Kiyasu enrolled in Medicare?

Yes. Phillip Kiyasu is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Phillip Kiyasu's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Phillip Kiyasu reassigns Medicare benefits to The Oregon Clinic PC (Portland, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Phillip Kiyasu's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Phillip Kiyasu accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Phillip Kiyasu as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Phillip Kiyasu was last updated on November 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.