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

Q: 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.

Q: What is Justin Tidwell's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Justin Tidwell was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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: July 19, 2026.

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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

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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 13

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, 20-29 minutes 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.

182 services108 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.

117 services15 patients

New patient office or other outpatient visit, 30-44 minutes 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.

114 services114 patients

Established patient office or other outpatient visit, 30-39 minutes 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.

69 services42 patients

Removal of noncancer thickened skin growth, 1 growth 11055

This procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.

41 services30 patients

Removal of skin and tissue, 20.0 sq cm or less 11042

40 services13 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.

31 services21 patients

Established patient office or other outpatient visit, 30-39 minutes 99214

31 services11 patients

Removal of fingernails or toenails, 6 or more nails 11721

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

25 services13 patients

X-ray of ankle, minimum of 3 views 73610

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

17 services11 patients

Established patient office or other outpatient visit, 10-19 minutes 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

14 services14 patients

Initial hospital inpatient care per day, typically 50 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.

13 services12 patients

Removal of noncancer thickened skin growth, 2-4 growths 11056

This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.

12 services11 patients

Hospital Affiliations CMS Care Compare 2

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 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

Quality

91.54

Promoting Interoperability

100

Improvement Activities

Cost

70.7

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.

DR. AMY Z SCHMITKE M.D.

Specialist

501 N GRAHAM ST, SUITE 525
PORTLAND, OR 97227

Multnomah County (503) 249-5454

DR. THOMAS O FLATH M.D.,

Specialist

501 N GRAHAM ST, SUITE 525
PORTLAND, OR 97227

Multnomah County (503) 249-5454

DOUGLAS H KING MD

Pediatrics (Pediatric Cardiology)

501 N GRAHAM ST, #220
PORTLAND, OR 97227

Multnomah County (503) 280-3418

DAVID M MCIRVIN MD

Pediatrics (Pediatric Cardiology)

501 N GRAHAM ST, #220
PORTLAND, OR 97227

Multnomah County (503) 280-3418

MR. JUDAH GOLD-MARKEL PA-C

Physician Assistant

501 N GRAHAM ST, SUITE 415
PORTLAND, OR 97227

Multnomah County (503) 413-3580

DR. ALEXANDER DEMETRE NICOLOFF M.D.

Surgery (Vascular Surgery)

501 N GRAHAM ST, SUITE 415
PORTLAND, OR 97227

Multnomah County (503) 413-3580

MRS. PATRICIA KREINBERG VROOMAN CPNP

Nurse Practitioner (Pediatrics)

501 N GRAHAM ST, SUITE 355
PORTLAND, OR 97227

Multnomah County (503) 413-2560

MAYA KOIKE HUNTER MD

Pediatrics (Pediatric Endocrinology)

501 N GRAHAM ST, SUITE 375
PORTLAND, OR 97227

Multnomah County (503) 413-1600

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 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 with the weekly NPPES data releases published by CMS.