ETHAN KIMBALL DO
NPI 1407484934
Emergency Medicine in Portland, OR
About Ethan Kimball Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ETHAN KIMBALL DO (NPI 1407484934) is an individual emergency medicine provider in Portland, Oregon, licensed in Oregon (DO209426) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS, is affiliated with Ohsu Hospital And Clinics, and maintains a secondary practice location in Newport.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted 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
Ethan Kimball Do 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.
Medicare Billing Reassignments
4Medicare enrollment records show Ethan Kimball reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Portland, OR 97239
- Reassigned Medicare billing, Oregon enrollment
- 2,212 clinicians in this Medicare group
Portland, OR 97216
- Reassigned Medicare billing, Oregon enrollment
- 331 clinicians in this Medicare group
Hillsboro, OR 97123
- Reassigned Medicare billing, Oregon enrollment
- 691 clinicians in this Medicare group
Depoe Bay, OR 97341
- Reassigned Medicare billing, Oregon enrollment
- 348 clinicians in this Medicare group
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 5
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.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Ohsu Hospital And Clinics
Acute Care Hospitals · Portland, ORHillsboro Medical Center
Acute Care Hospitals · Hillsboro, ORAdventist Health Portland
Acute Care Hospitals · Portland, ORPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97239 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
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 Ethan Kimball's NPI number?
The NPI number for Ethan Kimball is 1407484934. It was assigned to this individual provider in the NPPES registry on March 30, 2020.
Where is Ethan Kimball located?
Ethan Kimball practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 494-8211.
What is Ethan Kimball's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Ethan Kimball enrolled in Medicare?
Yes. Ethan Kimball is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Ethan Kimball's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Kimball reassigns Medicare benefits to 4 organizations: University Professional Services (Portland, OR), Portland Adventist Medical Center (Portland, OR), Tuality Medical Group LLC (Hillsboro, OR) and Samaritan Pacific Health Services, Inc. (Depoe Bay, OR). Each 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 Ethan Kimball's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Ethan Kimball accept?
Health plans from Moda Health Plan, Inc. list Ethan Kimball 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.
Is Ethan Kimball affiliated with any hospitals?
According to CMS data, Ethan Kimball is affiliated with Ohsu Hospital And Clinics, Hillsboro Medical Center and Adventist Health Portland.
When was this NPI record last updated?
The NPPES record for Ethan Kimball was last updated on January 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.
# Ethan Kimball, DO · NPI 1407484934
Emergency Medicine physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since March 30, 2020.
## Identity
- **NPI:** 1407484934 (Entity type: Individual)
- **Enumerated:** March 30, 2020
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** DO209426 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 3181 SW SAM JACKSON PARK RD, Portland, OR 97239-3011
- **Phone:** (503) 494-8211
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): University Professional Services (NPI 1376709535, Portland, OR); Portland Adventist Medical Center (NPI 1437925310, Portland, OR); Tuality Medical Group LLC (NPI 1639690704, Hillsboro, OR); Samaritan Pacific Health Services, Inc. (NPI 1912257460, Depoe Bay, OR) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Touro Un College Of Osteopathic Medicine, Vallejo, class of 2020
## Record status
- **NPPES last updated:** January 17, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1407484934) · Data from the CMS NPPES public registry.