MUSAH N IDDRISU RN
NPI 1124627054
Nurse Practitioner in Portland, OR

Active since October 21, 2020PECOS Enrolled
12710 SE DIVISION ST, PORTLAND, OR 97236(503) 988-3601 Get Directions Write a Review

NPPES record last updated: November 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 7, 2023, Oct 21, 2020 (2 updates tracked since 2020).

About Musah N Iddrisu Rn NPPES

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

MUSAH N IDDRISU RN (NPI 1124627054) is an individual nurse practitioner in Portland, Oregon, licensed in Oregon (10017169) and active in the NPI registry since October 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124627054
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameMUSAH N IDDRISUCredential: RN
Location Address12710 SE DIVISION STPortland, OR 97236-3134
Mailing Address619 Nw 6th Ave Fl 5Portland, OR 97209-3964 · (503) 988-7468
Sole ProprietorNo
Enumeration DateOctober 21, 2020
Last NPPES UpdateNovember 7, 20232 updates tracked since enumeration
NPPES CertifiedNovember 7, 2023
NPI 1124627054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in OR · 10017169
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

12710 SE DIVISION ST, Portland, OR 97236

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Musah N Iddrisu Rn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97236 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
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
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.

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.

Dentist (General Practice)
12710 SE DIVISION ST
PORTLAND, OR 97236
Dentist
12710 SE DIVISION ST
PORTLAND, OR 97236
Social Worker (Clinical)
12710 SE DIVISION ST
PORTLAND, OR 97236
Dentist (General Practice)
12710 SE DIVISION ST
PORTLAND, OR 97236
Physician Assistant (Medical)
12710 SE DIVISION ST
PORTLAND, OR 97236
Nurse Practitioner (Family)
12710 SE DIVISION ST
PORTLAND, OR 97236
Dentist
12710 SE DIVISION ST
PORTLAND, OR 97236
Clinic/Center (Federally Qualified Health Center (FQHC))
12710 SE DIVISION ST
PORTLAND, OR 97236

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 Musah Iddrisu's NPI number?

The NPI number for Musah Iddrisu is 1124627054. It was assigned to this individual provider in the NPPES registry on October 21, 2020.

Where is Musah Iddrisu located?

Musah Iddrisu practices at 12710 SE Division St, Portland, OR 97236. The listed phone number is (503) 988-3601.

What is Musah Iddrisu's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Musah Iddrisu enrolled in Medicare?

Yes. Musah Iddrisu is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Musah Iddrisu was last updated on November 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.