Dr Long Earon Thao, DO is a medicare enrolled "Hospitalist" physician in Gresham, Oregon. His current practice location is
24800 Se Stark St, Gresham, Oregon. You can reach out to his office (for appointments etc.) via phone at
(503) 413-8407.
Dr Long Earon Thao is licensed to practice in Oregon (license number DO27806) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1770780165.
Physician's Profile
| Full Name | Dr Long Earon Thao |
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| Gender | Male |
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| Speciality | Hospitalist |
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| Location | 24800 Se Stark St, Gresham, Oregon |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1770780165
- Provider Enumeration Date: 06/28/2007
- Last Update Date: 12/22/2021
Medicare PECOS Information:
- PECOS PAC ID: 8022177443
- Enrollment ID: I20111215000874
Medical Identifiers
Medical identifiers for Dr Long Earon Thao such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770780165 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208M00000X | Hospitalist | DO27806 (Oregon) | Primary |
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. Dr Long Earon Thao allows following entities to bill medicare on his behalf.
| Entity Name | Permanente Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710 |
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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. Dr Long Earon Thao 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 |
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Dr Long Earon Thao, DO
2650 Ne 6th Pl,
Portland, OR 97212-3880
Ph: (503) 867-7530 | Dr Long Earon Thao, DO
24800 Se Stark St,
Gresham, OR 97030-3378
Ph: (503) 413-8407 |
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