SHEA MERTENS DEKLOTZ (PA-C) – Surgical Physician Assistant, NPI 1679819239
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,876 PHYSICIAN ASSISTANT in OR
Provider Addresses for SHEA MERTENS DEKLOTZ (PA-C)
2020 8th Ave Ste 200
West Linn, OR 970684657
Phone: (503) 512-1212
Type: Location
2020 8TH AVE STE 200
WEST LINN, OR 970684657
Phone:
Type: Mailing
1400 SW 5TH AVE STE 500
PORTLAND, OR 972015537
Phone:
Fax: (503) 346-8015
Type: Mailing
3303 S BOND AVE
PORTLAND, OR 972394501
Phone: (503) 494-4314
Fax: (503) 346-6810
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 149 Open Payments records for all available years, with a total value of $2,198.
Total Amount is formed as General ($2,198) + Research ($0) + Ownership ($0) = $2,198.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Collegium Pharmaceutical, Inc. ($566).
Total Amount
$2,198
General + Research + Ownership
Payments
149
Total payment records
General Amount
$2,198
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Collegium Pharmaceutical, Inc. | $566 |
| ABBVIE INC. | $453 |
| Medtronic, Inc. | $344 |
| PFIZER INC. | $208 |
| Lundbeck LLC | $95 |
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: 2013-01-29
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 |
|---|---|---|---|---|
| I20130129000548 | I | Physician Assistant | OR | 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 97068)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OR | |
| Diagnostic Radiology | TN | |
| - | OR | |
| Nurse Practitioner | OR | |
| - | OR | |
| - | OR | |
| General Surgery, Thoracic Surgery | WA | |
| - | OR | |
| - | OR | |
| - | WA |
Reviews
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