MRS. MENDY L MULLIS (C-PA) – Physician Assistant, NPI 1063744456
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MRS. MENDY L MULLIS (C-PA)
Java Lounge, 760, Northwest Dale Avenue, Cedar Mill, Portland, Metro, Washington County, Oregon, 97229, United States
WASHINGTON, IN 475010760
Phone: (812) 254-2760
Fax: (812) 254-8636
Type: Mailing
West Mill Street, Odon, Daviess County, Indiana, 47562, United States
ODON, IN 475621032
Phone: (812) 636-7300
Fax: (812) 257-7073
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 24 Open Payments records for all available years, with a total value of $394.
Total Amount is formed as General ($394) + Research ($0) + Ownership ($0) = $394.
Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Amgen Inc. ($89).
Total Amount
$394
General + Research + Ownership
Payments
24
Total payment records
General Amount
$394
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Amgen Inc. | $89 |
| Novo Nordisk Inc | $86 |
| ABBVIE INC. | $77 |
| Insulet Corporation | $23 |
| Takeda Pharmaceuticals U.S.A., Inc. | $23 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-03-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100312000579 | I | Physician Assistant | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 47501)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| A N E S T H E S I O L O G Y | IN | |
| Emergency Medicine | SC | |
| Internal Medicine | IN | |
| - | IN | |
| Nurse Practitioner | IN | |
| Clinical Social Worker | IN | |
| Nurse Practitioner | IN | |
| - | IN | |
| General Surgery | OH | |
| Nurse Practitioner | IN |
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