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JUSTIN ALAN TIDWELL DPM
NPI 1710908892
Podiatrist - Foot & Ankle Surgery in Portland, OR

Active since July 22, 2006PECOS EnrolledAccepts Medicare Assignment
88.67/100
CMS Quality Rating
501 N GRAHAM ST, SUITE 415, PORTLAND, OR 97227(503) 413-2005(503) 413-3699 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Justin Alan Tidwell Dpm NPPES

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

JUSTIN ALAN TIDWELL DPM (NPI 1710908892) is an individual foot & ankle surgery provider in Portland, Oregon, licensed in Oregon (DP00373) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Legacy Emanuel Medical Center, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1710908892
Entity TypeIndividualMale
Primary Taxonomy213ES0103X
Provider Legal NameJUSTIN ALAN TIDWELLCredential: DPM
Location Address501 N GRAHAM ST, SUITE 415Portland, OR 97227-1654
Mailing Address5815 Ne 23rd AvePortland, OR 97211-5447 · (503) 936-7454
Phone(503) 413-2005
Fax(503) 413-3699
Sole ProprietorYes
Medical School CMSOtherGraduated 2003
Enumeration DateJuly 22, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1710908892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
Licenses✔ Licensed in OR · DP00373✔ Licensed in WA · PO00000806
501 N GRAHAM ST, Portland, OR 97227
Open in Google Maps ↗

Other Identifiers 1

Medicare UPINV06772NM

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc. and more.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

Justin Alan Tidwell Dpm 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 ID42244725
PECOS Enrollment IDI20070206000698, I20070911000071
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 9

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

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 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.
211 services76 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
169 services169 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
132 services91 patients
Removal of skin and tissue, 20.0 sq cm or less 11042
This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.
35 services16 patients
X-ray of foot, minimum of 3 views 73630
An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.
21 services16 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
20 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

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

Legacy Salmon Creek Medical Center

Acute Care Hospitals · Vancouver, WA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number500150
Location2211 NE 139th StreetVancouver, WA 98686 · Clark County
Emergency services Birthing friendly

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.

88.67/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality91.54
Promoting Interoperability100
Improvement Activities40
Cost70.7

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500
DME-Orthotic Devices · category DF000N
5 suppliers14 claims28 services$57.78 avg. paid by Medicare
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each A5513
DME-Orthotic Devices · category DF000N
5 suppliers11 claims58 services$37.32 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

JAMES FRANCIS DEITLE PA-C
Physician Assistant
501 N GRAHAM ST, SUITE #580
PORTLAND, OR 97227
Multnomah County (503) 528-0704
EVERGREEN PROSTHETICS AND ORTHOTICS, LLC
Prosthetic/Orthotic Supplier
501 N GRAHAM ST, STE 255
PORTLAND, OR 97227
Multnomah County (503) 288-9929
HELEN MONTIE MSN, APRN, CPNP-PC
Nurse Practitioner (Pediatrics)
501 N GRAHAM ST
PORTLAND, OR 97227
Multnomah County (503) 413-2200
DR. KARIN ANN SELVA MD
Pediatrics (Pediatric Endocrinology)
501 N GRAHAM ST, SUITE 375
PORTLAND, OR 97227
Multnomah County (503) 413-1600
SURGICAL CENTER, INC
Surgery
501 N GRAHAM ST, SUITE 555
PORTLAND, OR 97227
Multnomah County (503) 288-7535
EMANUEL CHILDREN'S DIABETES AND ENDOCRINE CENTER
Clinic/Center
501 N GRAHAM ST, SUITE 375
PORTLAND, OR 97227
Multnomah County (503) 413-1600
MRS. PATRICIA KREINBERG VROOMAN CPNP
Nurse Practitioner (Pediatrics)
501 N GRAHAM ST, SUITE 355
PORTLAND, OR 97227
Multnomah County (503) 413-2560
CYNTHIA ANN GINGALEWSKI MD
Surgery (Pediatric Surgery)
501 N GRAHAM ST, MOB 2 SUITE 300
PORTLAND, OR 97227
Multnomah County (503) 413-4300

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 Justin Tidwell's NPI number?

The NPI number for Justin Tidwell is 1710908892. It was assigned to this individual provider in the NPPES registry on July 22, 2006.

Where is Justin Tidwell located?

Justin Tidwell practices at 501 N Graham St Suite 415, Portland, OR 97227. The listed phone number is (503) 413-2005.

What is Justin Tidwell's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Is Justin Tidwell enrolled in Medicare?

Yes. Justin Tidwell is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Justin Tidwell accept?

Health plans from BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc., PacificSource Health Plans and Providence Health Plan and 1 other insurer list Justin Tidwell as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Justin Tidwell affiliated with any hospitals?

According to CMS data, Justin Tidwell is affiliated with Legacy Emanuel Medical Center, Legacy Good Samaritan Medical Center and Legacy Salmon Creek Medical Center.

When was this NPI record last updated?

The NPPES record for Justin Tidwell was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.