Mohammad Hissourou Iii, MD in Portland, OR

Mohammad Hissourou Iii, MD is a medicare enrolled "Radiology - Radiation Oncology" physician in Portland, Oregon. His current practice location is 808 Sw Campus Dr, Portland, Oregon. You can reach out to his office (for appointments etc.) via phone at (503) 494-8756.

Mohammad Hissourou Iii is licensed to practice in Oregon (license number MD209773) 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 1538664057.

Contact Information

	Mohammad Hissourou Iii, MD
	808 Sw Campus Dr, Portland, OR 97239-3008
	(503) 494-8756
	Not Available

Map and Direction

Physician's Profile

Full Name	Mohammad Hissourou Iii
Gender	Male
Speciality	Radiology - Radiation Oncology
Location	808 Sw Campus Dr, Portland, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1538664057
Provider Enumeration Date: 03/27/2018
Last Update Date: 06/06/2023

Medicare PECOS Information:

PECOS PAC ID: 7911241674
Enrollment ID: I20230424002711

Medical Identifiers

Medical identifiers for Mohammad Hissourou Iii such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1538664057	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2085R0001X	Radiology - Radiation Oncology	MD209773 (Oregon)	Primary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary

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. Mohammad Hissourou Iii allows following entities to bill medicare on his behalf.

Entity Name	Sky Lakes Medical Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1659340370 PECOS PAC ID: 1052204096 Enrollment ID: O20040204000577

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. Mohammad Hissourou Iii 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
Mohammad Hissourou Iii, MD 1900 Nw Myhre Rd, Silverdale, WA 98383-7662 Ph: (564) 240-3100	Mohammad Hissourou Iii, MD 808 Sw Campus Dr, Portland, OR 97239-3008 Ph: (503) 494-8756

Reviews and Comments

Radiology Doctors in Portland, OR

Gregory Hall, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-418-0990 Fax: 503-494-4982
Deborah Janet Cohen, MD Radiology Medicare: Medicare Enrolled Practice Location: 3710 Sw Veterans Hospital Rd, Portland, OR 97239 Phone: 503-539-4903
Erik W Foss, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-2570
Hans Guenter Wandel, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-418-0990
Steven Lloyd Primack, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-418-0990
Dr. James S Putnam, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 9205 Sw Barnes Rd, Portland, OR 97225 Phone: 503-216-4830 Fax: 503-216-4850
D. Bradley Koslin, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-418-0990

Mohammad Hissourou Iii, MD - Medicare Radiology in Portland, OR