Marshall Albert Canizalez, AUD is a medicare enrolled "Audiologist" provider in Gresham, Oregon. His current practice location is
24076 Se Stark St Ste 230, Gresham, Oregon. You can reach out to his office (for appointments etc.) via phone at
(503) 488-2600.
Marshall Albert Canizalez is licensed to practice in Oregon (license number 31054) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1376205278.
Healthcare Provider's Profile
| Full Name | Marshall Albert Canizalez |
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| Gender | Male |
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| Speciality | Audiologist |
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| Location | 24076 Se Stark St Ste 230, Gresham, Oregon |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1376205278
- Provider Enumeration Date: 10/07/2021
- Last Update Date: 12/29/2022
Medicare PECOS Information:
- PECOS PAC ID: 4880064732
- Enrollment ID: I20230110002296
Medical Identifiers
Medical identifiers for Marshall Albert Canizalez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1376205278 | NPI | - | NPPES |
| 500813168 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 231H00000X | Audiologist | 147001852 (Illinois) | Secondary |
| 237600000X | Audiologist-hearing Aid Fitter | (* (Not Available)) | Secondary |
| 231H00000X | Audiologist | 31054 (Oregon) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Marshall Albert Canizalez allows following entities to bill medicare on his behalf.
| Provider Name | Kaiser Foundation Health Plan Of The Northwest |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1184786527
PECOS PAC ID: 5799688230
Enrollment ID: O20040130000799 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Marshall Albert Canizalez is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Marshall Albert Canizalez, AUD
847 Ne 19th Ave Ste 300,
Portland, OR 97232-2686
Ph: (503) 963-2801 | Marshall Albert Canizalez, AUD
24076 Se Stark St Ste 230,
Gresham, OR 97030-3385
Ph: (503) 488-2600 |
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