PAUL DAVID MORTLOCK (PA-C) – Medical Physician Assistant, NPI 1376506733
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,282 PHYSICIAN ASSISTANT in WA
Provider Addresses for PAUL DAVID MORTLOCK (PA-C)
2101 NE 139th St Ste 380
Vancouver, WA 986862309
Phone: (360) 487-1888
Type: Location
33rd Avenue West, Lynnwood, Snohomish County, Washington, 98037, United States
LYNNWOOD, WA 980364748
Phone: (425) 563-1500
Fax: (425) 563-1374
Type: Mailing
PeaceHealth Southwest Medical Center, 400, Northeast Mother Joseph Place, Vancouver, Clark County, Washington, 98664, United States
VANCOUVER, WA 986643200
Phone: (360) 892-9664
Fax: (360) 892-9667
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $521.
Total Amount is formed as General ($521) + Research ($0) + Ownership ($0) = $521.
Last reported payment date: 2024-07-10 • Largest payer in this snapshot: Inari Medical, Inc. ($383).
Total Amount
$521
General + Research + Ownership
Payments
5
Total payment records
General Amount
$521
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Inari Medical, Inc. | $383 |
| Penumbra, Inc. | $138 |
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: 2005-05-09
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 |
|---|---|---|---|---|
| I20050509000382 | I | Physician Assistant | WA | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99152 | Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes | 109 | 104 | $0 |
| 77012 | Review by radiologist of ct guidance for needle placement | 57 | 55 | $0 |
| 49083 | Drainage of fluid from abdominal cavity using imaging guidance | 32 | 22 | $0 |
| 32555 | Aspiration of fluid from chest cavity using imaging guidance | 26 | 26 | $0 |
| 38221 | Biopsy of bone marrow | 18 | 18 | $0 |
Insurance plans in this area (ZIP 98686)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | WA | 62311 | Injections of substances into lower or sacral spine | 19 | 17 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | WA | |
| - | WA | |
| Diagnostic Radiology | WA | |
| - | WA | |
| Diagnostic Radiology | MO | |
| Diagnostic Radiology | WA | |
| Diagnostic Radiology | WA | |
| Diagnostic Radiology | OH | |
| Diagnostic Radiology | WA | |
| Diagnostic Radiology | TN |
Reviews
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