| John Noel Dussel, MD | |
|
25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070-9816 | |
| (971) 434-0080 | |
| (503) 946-3891 |
| Full Name | John Noel Dussel |
|---|---|
| Gender | Male |
| Speciality | Vascular Surgery |
| Experience | 14 Years |
| Location | 25030 Sw Parkway Ave Ste 200, Wilsonville, Oregon |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902192396 | NPI | - | NPPES |
| 222469 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0129X | Surgery - Vascular Surgery | MD188768 (Oregon) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Providence St Vincent Medical Center | Portland, OR | Hospital |
| Providence Portland Medical Center | Portland, OR | Hospital |
| Providence Newberg Medical Center | Newberg, OR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Oregon Vascular Specialists Llc | 8022386663 | 11 |
| Entity Name | Providence Health & Services Oregon |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023488343 PECOS PAC ID: 0648183608 Enrollment ID: O20031106000652 |
| Entity Name | Providence Health & Services - Oregon |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003991845 PECOS PAC ID: 5395656284 Enrollment ID: O20031113000626 |
| Entity Name | Providence Health & Services - Oregon |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114015971 PECOS PAC ID: 9335057447 Enrollment ID: O20031117000153 |
| Entity Name | Oregon Vascular Specialists Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669917167 PECOS PAC ID: 8022386663 Enrollment ID: O20170622001858 |
| Mailing Address | Practice Location Address |
|---|---|
| John Noel Dussel, MD 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070-9816 Ph: (971) 434-0080 | John Noel Dussel, MD 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070-9816 Ph: (971) 434-0080 |
Dr. Richard Brad Cook, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070 Phone: 971-434-0080 Fax: 503-946-3891 | |
Brant William Ullery, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070 Phone: 971-434-0080 Fax: 503-946-3891 | |
Vincent Joseph Santo Iii, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070 Phone: 971-434-0080 Fax: 503-946-3891 |