DR. KEITH PHILLIP CROSS M.D. NPI 1528105194

NPI Information

  • NPI: 1528105194
  • Provider Name: DR. KEITH PHILLIP CROSS, M.D.
  • Classification: Emergency Medicine - 207PP0204X
  • Specialization: Pediatric Emergency Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3181 SW SAM JACKSON PARK RD
    PORTLAND, OR
    ZIP 97239
  • Phone: (503) 494-7551

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NPI Details

DR. Keith Phillip Cross, M.D. is a pediatric emergency medicine emergency medicine in Portland, OR with 23 years of experience. The provider is pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department. DR. Keith Phillip Cross, M.D. NPI is 1528105194. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
Graduation Year:2003

The provider's business location address is:

3181 SW SAM JACKSON PARK RD
PORTLAND, OR
ZIP 97239-011
Phone: (503) 494-7551
Fax: (503) 494-4997

The NPI 1528105194 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/31/2007 and was last updated on 3/15/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics294757-1NEW YORKNo
2208000000XPediatricsMD214291OREGONNo
32080P0204XPediatricsPediatric Emergency Medicine40990KENTUCKYNo
42080P0204XPediatricsPediatric Emergency Medicine294757-1NEW YORKNo
5207PP0204XEmergency MedicinePediatric Emergency MedicineMD214291OREGONYes
6207R00000XInternal MedicineMD214291OREGONNo
7208000000XPediatrics40990KENTUCKYNo
8207R00000XInternal Medicine40990KENTUCKYNo
9207R00000XInternal Medicine294757-1NEW YORKNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200882960MEDICAIDINDIANA
27100025500MEDICAIDKENTUCKY
303822786MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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