Justin Alan Tidwell, DPM in Portland, OR - Medicare Podiatry Provider

Justin Alan Tidwell, DPM is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Portland, Oregon. He graduated from medical school in 2003 and has 21 years of diverse experience with area of expertise as Podiatry. He is a member of the group practice Legacy Clinics Llc, Legacy Salmon Creek Hospital and his current practice location is 501 N Graham St, Suite 415, Portland, Oregon. You can reach out to his office (for appointments etc.) via phone at (503) 413-2005.

Justin Alan Tidwell is licensed to practice in Oregon (license number DP00373) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1710908892.

Contact Information

	Justin Alan Tidwell, DPM
	501 N Graham St, Suite 415, Portland, OR 97227-1654
	(503) 413-2005
	(503) 413-3699

Map and Direction

Healthcare Provider's Profile

Full Name	Justin Alan Tidwell
Gender	Male
Speciality	Podiatry
Experience	21 Years
Location	501 N Graham St, Portland, Oregon
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Justin Alan Tidwell graduated from medical school in 2003

NPI Data:

NPI Number: 1710908892
Provider Enumeration Date: 07/22/2006
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 0042244725
Enrollment ID: I20070206000698

Medical Identifiers

Medical identifiers for Justin Alan Tidwell such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1710908892	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
213ES0103X	Podiatrist - Foot & Ankle Surgery	PO00000806 (Washington)	Secondary
213ES0103X	Podiatrist - Foot & Ankle Surgery	DP00373 (Oregon)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Legacy Emanuel Medical Center	Portland, OR	Hospital
Legacy Good Samaritan Medical Center	Portland, OR	Hospital
Legacy Salmon Creek Medical Center	Vancouver, WA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Legacy Clinics Llc	0244144004	633
Legacy Salmon Creek Hospital	0446295711	236

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. Justin Alan Tidwell allows following entities to bill medicare on his behalf.

Provider Name	Legacy Clinics Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1902827272 PECOS PAC ID: 0244144004 Enrollment ID: O20031117000089

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. Justin Alan Tidwell 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
Justin Alan Tidwell, DPM 5815 Ne 23rd Ave, Portland, OR 97211-5447 Ph: (503) 936-7454	Justin Alan Tidwell, DPM 501 N Graham St, Suite 415, Portland, OR 97227-1654 Ph: (503) 413-2005

Reviews and Comments

Podiatrist in Portland, OR

Barnes Foot And Ankle Podiatrist Medicare: Medicare Enrolled Practice Location: 9615 Nw Randall Ln, Portland, OR 97229 Phone: 503-297-2222
Edward Theodore Ysunza Iv, Podiatrist Medicare: Medicare Enrolled Practice Location: 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239 Phone: 503-220-8262
Dr. Brian M. Bowen, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1717 Ne 42nd Ave, Suite 3300, Portland, OR 97213 Phone: 503-284-2000 Fax: 503-284-2002
Town Center Foot Clinic Podiatrist Medicare: Medicare Enrolled Practice Location: 8305 Se Monterey Ave Ste 101, Portland, OR 97266 Phone: 503-652-1121 Fax: 503-652-2193
Ray A Mcclanahan, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 725 Nw 19th Ave, Portland, OR 97209 Phone: 503-243-2699 Fax: 503-243-2698
Portland Foot And Ankle Institute, Llc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 12672 Nw Barnes Rd Ste 100, Portland, OR 97229 Phone: 503-336-0169 Fax: 503-352-4583
Dr. Steven Gary Tillett, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 6274 Sw Capitol Hwy, Portland, OR 97239 Phone: 503-246-2212

Justin Alan Tidwell, DPM - Medicare Podiatrist in Portland, OR