Andre D Grisham, MD - Medicare General Surgery in Tigard, OR

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Andre D Grisham, MD is a medicare enrolled "Surgery" physician in Tigard, Oregon. He went to University Of Kentucky College Of Medicine and graduated in 1999 and has 25 years of diverse experience with area of expertise as General Surgery. He is a member of the group practice Portland Clinic, Providence Health And Services Oregon and his current practice location is 9250 Sw Hall Blvd, Tigard, Oregon. You can reach out to his office (for appointments etc.) via phone at (503) 221-0161.

Andre D Grisham is licensed to practice in Oregon (license number MD151172) 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 1629042122.

Contact Information

Andre D Grisham, MD
9250 Sw Hall Blvd,
Tigard, OR 97223-6721
(503) 221-0161
Not Available

Map and Direction




Physician's Profile

Full NameAndre D Grisham
GenderMale
SpecialityGeneral Surgery
Experience25 Years
Location9250 Sw Hall Blvd, Tigard, Oregon
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Andre D Grisham attended and graduated from University Of Kentucky College Of Medicine in 1999
  NPI Data:
  • NPI Number: 1629042122
  • Provider Enumeration Date: 02/14/2006
  • Last Update Date: 07/21/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 1355325184
  • Enrollment ID: I20130801000794

Medical Identifiers

Medical identifiers for Andre D Grisham such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1629042122NPI-NPPES
3895467MedicaidTN
4214668OtherTNBCBS TN
04951725MedicaidMS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208600000XSurgery 29462 (South Carolina)Secondary
208600000XSurgery 38146 (Tennessee)Secondary
208600000XSurgery MD151172 (Oregon)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Providence St Vincent Medical CenterPortland, ORHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Portland Clinic822494286783
Providence Health And Services Oregon06481836081328

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. Andre D Grisham allows following entities to bill medicare on his behalf.
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023488343
PECOS PAC ID: 0648183608
Enrollment ID: O20031106000652
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114015971
PECOS PAC ID: 9335057447
Enrollment ID: O20031117000153
Entity NamePortland Clinic
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1558379099
PECOS PAC ID: 8224942867
Enrollment ID: O20031118000101
Entity NameProvidence Health & Services Oregon
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578500492
PECOS PAC ID: 1557260106
Enrollment ID: O20040102000768

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. Andre D Grisham 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 AddressPractice Location Address
Andre D Grisham, MD
800 Sw 13th Ave,
Portland, OR 97205-1902

Ph: (503) 221-0161		Andre D Grisham, MD
9250 Sw Hall Blvd,
Tigard, OR 97223-6721

Ph: (503) 221-0161

Reviews and Comments


Surgery Doctors in Tigard, OR

Dr. Jason Christopher Gilster, M.D.
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 7421 Sw Bridgeport Rd Ste 215, Tigard, OR 97224
Phone: 971-297-3007    Fax: 503-598-7765
Burkley Snow, M.D.
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 9250 Sw Hall Blvd, Tigard, OR 97223
Phone: 503-293-0161    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.