KIRSTIE LAUREN WILSON-PANUM M.D.
NPI 1386910818
Obstetrics & Gynecology in Portland, OR

Q: What is Kirstie Wilson-panum's NPI number?

The NPI number for Kirstie Wilson-panum is 1386910818. It was assigned to this individual provider in the NPPES registry on March 29, 2012.

Q: What is Kirstie Wilson-panum's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Active since March 29, 2012PECOS EnrolledAccepts Medicare Assignment

501 N GRAHAM ST STE 550, PORTLAND, OR 97227(503) 284-5220(503) 284-4971 Get Directions Write a Review

NPPES record last updated: November 11, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 11, 2024, Nov 21, 2023, Nov 24, 2021 and 1 more (4 updates tracked since 2017).

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About Kirstie Lauren Wilson-panum M.d. NPPES

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

KIRSTIE LAUREN WILSON-PANUM M.D. (NPI 1386910818) is an individual obstetrics & gynecology provider in Portland, Oregon, licensed in Oregon (MD171212) and active in the NPI registry since March 2012. She is enrolled in Medicare PECOS, is affiliated with Legacy Emanuel Medical Center, and is a graduate of Georgetown University School Of Medicine (2008).

NPPES Registry Identity

NPI1386910818

Entity TypeIndividualFemale

Primary Taxonomy207V00000X

Provider Legal NameKIRSTIE LAUREN WILSON-PANUMCredential: M.D.

Location Address501 N GRAHAM ST STE 550Portland, OR 97227-2010

Mailing Address541 Ne 20th Ave Ste 225Portland, OR 97232-2895 · (503) 963-2801 · Fax (503) 963-2825

Phone(503) 284-5220

Fax(503) 284-4971

Sole ProprietorNo

Medical School CMSGeorgetown University School Of MedicineGraduated 2008

Enumeration DateMarch 29, 2012

Last NPPES UpdateNovember 11, 20244 updates tracked since enumeration

NPPES CertifiedNovember 11, 2024

✔ NPI 1386910818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

Licenses✔ Licensed in OR · MD171212✔ Licensed in NY · 264220-1

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

501 N GRAHAM ST STE 550, Portland, OR 97227

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Other Identifiers 2

Medicaid500690961OR

Medicaid2047045WA

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 and accepts Medicare assignment

Kirstie Lauren Wilson-panum M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2769630011

PECOS Enrollment IDI20150903002766

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 Reassignments

Medicare enrollment records show Kirstie Wilson-panum reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Oregon Clinic PC

1.7 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

Providence Health & Services - Oregon

3.1 mi

General Acute Care Hospital

4805 NE GLISAN ST
Portland, OR 97213

Reassigned Medicare billing, Oregon enrollment
676 clinicians in this Medicare group

NPI 1003991845 (503) 451-3000

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

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Legacy Emanuel Medical Center

Acute Care Hospitals · Portland, OR

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380007

Location2801 N Gantenbein AvenuePortland, OR 97227 · Multnomah County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97227 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

$73.28 typical visit price

range $19.32 – $144.79

Typical copayment $18.32 (range $4.83 – $36.19)

Most-billed visit code 99213

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 14

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

ERIKA GENE COPPERMAN DO

Obstetrics & Gynecology