ALAN K MIRLY (PA) – Physician Assistant, NPI 1891780524

ALAN K MIRLY (PA) is a healthcare provider. based in Portland, Oregon. specializing in Physician Assistant. They hold the professional credentials PA. They hold a License No. PA-558 (ID). The NPI Number for ALAN K MIRLY (PA) is 1891780524

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
ALAN K MIRLY (PA)
NPI
1891780524
Phone
(360) 882-2778
Address
PO BOX 4825
Enumeration Date
19 September 2005
Last Update Date
9 December 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3608822778
Graduation Year
2002 (24 years ago)
PAC ID
6204821606
Group Practice PAC ID
3173436490
Professional Enrollment ID
I20200316001222
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

Provider Addresses for ALAN K MIRLY (PA)

  • Portland Post Office, 320, Main Street, Gildersleeve, Portland, Lower Connecticut River Valley Planning Region, Connecticut, 06480, United States

    PORTLAND, OR 972084825

    Phone: (360) 882-2778

    Fax: (360) 604-1771

    Type: Mailing

  • 2525 NE 139TH ST STE 220

    VANCOUVER, WA 986862719

    Phone: (360) 882-2778

    Fax: (360) 604-1616

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2020-03-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050616001166IPhysician AssistantIDTBD
I20200316001222IPhysician AssistantWATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99203New patient office or other outpatient visit, 30-44 minutes1919$0
View full utilization report →

Insurance plans in this area (ZIP 97208)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173436490View full group profile
NameSpecialtyState
Physician AssistantTN
Internal Medicine, Infectious DiseasePA
Internal MedicineWA
Diagnostic RadiologyOR
Internal MedicineOR
O P H T H A L M O L O G YIA
-OR
Nurse PractitionerWA
Nurse PractitionerWA
Interventional Cardiology, Cardiovascular Disease (Cardiology)CA

Reviews

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Frequently asked questions

What is the standard ID for ALAN K MIRLY (PA) in the U.S.?
In the U.S., ALAN K MIRLY (PA) is identified by NPI 1891780524.
Is ALAN K MIRLY (PA)'s NPI status active today?
Active status means ALAN K MIRLY (PA)'s NPI record is not deactivated in the public file.
Which specialty label fits ALAN K MIRLY (PA)?
NPPES ties ALAN K MIRLY (PA) to Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to ALAN K MIRLY (PA)?
ALAN K MIRLY (PA) is associated with Portland, Oregon in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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