DR. KATHERINE ROLLINS BLACK MD
NPI 1801018122
Internal Medicine - Gastroenterology in Portland, OR

Active since May 03, 2007PECOS EnrolledAccepts Medicare Assignment
84.62/100
CMS Quality Rating
1130 NW 22ND AVE STE 410, PORTLAND, OR 97210(503) 229-7137(503) 241-0628 Get Directions Write a Review

NPPES record last updated: March 21, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Katherine Rollins Black Md NPPES

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

DR. KATHERINE ROLLINS BLACK MD (NPI 1801018122) is an individual gastroenterology provider in Portland, Oregon, licensed in Oregon (MD156824) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS, is affiliated with Legacy Emanuel Medical Center, and is a graduate of University Of South Carolina School Of Medicine (2012).

NPPES Registry Identity

NPI1801018122
Entity TypeIndividualFemale
Primary Taxonomy207RG0100X
Provider Legal NameDR. KATHERINE ROLLINS BLACKCredential: MD
Location Address1130 NW 22ND AVE STE 410Portland, OR 97210-2911
Mailing Address1130 Nw 22nd Ave Ste 410Portland, OR 97210-2911 · (503) 229-7137 · Fax (503) 241-0628
Fax(503) 241-0628
Sole ProprietorNo
Medical School CMSUniversity Of South Carolina School Of MedicineGraduated 2012
Enumeration DateMay 3, 2007
Last NPPES UpdateMarch 21, 2013
NPI 1801018122 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License Licensed in OR · MD156824
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.

1130 NW 22ND AVE STE 410, Portland, OR 97210

Other Identifiers 3

OtherMD156824OR · Provider State License
Medicare UPINR165158OR
Medicaid500647193OR

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Katherine Rollins Black Md 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 ID6002063211
PECOS Enrollment IDI20120823000132
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.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

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.
156 services67 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.
85 services84 patients
Established patient office or other outpatient visit, 30-39 minutes 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.
58 services50 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.
47 services47 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
42 services42 patients
Follow-up hospital inpatient care per day, typically 15 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
24 services19 patients

Hospital Affiliations CMS Care Compare 3

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

Ohsu Hospital And Clinics

Acute Care Hospitals · Portland, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number380009
Location3181 SW Sam Jackson Park RoadPortland, OR 97239 · Multnomah County
Emergency services Birthing friendly

Legacy Good Samaritan Medical Center

Acute Care Hospitals · Portland, OR
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380017
Location1015 NW 22nd Avenue, W121Portland, OR 97210 · Multnomah County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97210 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.

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.

84.62/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality94.83
Promoting Interoperability100
Improvement Activities40
Cost53.91

Reported Quality Measures

Photodocumentation of Cecal Intubation
The rate of screening and surveillance colonoscopies for which photodocumentation of landmarks of cecal intubation is performed to establish a complete examination
100%59 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 5

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

Internal Medicine (Gastroenterology)
1130 NW 22ND AVE STE 410
PORTLAND, OR 97210
Internal Medicine (Gastroenterology)
1130 NW 22ND AVE STE 410
PORTLAND, OR 97210
Specialist
1130 NW 22ND AVE STE 410
PORTLAND, OR 97210
Nurse Practitioner (Family)
1130 NW 22ND AVE STE 410
PORTLAND, OR 97210
Clinic/Center (Ambulatory Surgical)
1130 NW 22ND AVE STE 410
PORTLAND, OR 97210

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1801018122, enumerated as an "individual" on May 03, 2007.

The provider is located at 1130 NW 22ND AVE STE 410 PORTLAND, OR 97210 and the phone number is (503) 229-7137.

Internal Medicine with taxonomy code 207RG0100X and a focus in Gastroenterology.

The provider might be accepting Accepts: BridgeSpan Health Company, Kaiser Permanente,. Please consult your insurance carrier or call the provider to verify.

Katherine Black is affiliated with: LEGACY EMANUEL MEDICAL CENTER, OHSU HOSPITAL AND CLINICS and LEGACY GOOD SAMARITAN MEDICAL CENTER.