MALLORY FILLMORE PA-C
NPI 1215272505
Physician Assistant in Corvallis, OR

Q: What is Mallory Fillmore's NPI number?

The NPI number for Mallory Fillmore is 1215272505. It was assigned to this individual provider in the NPPES registry on November 28, 2012.

Q: What is Mallory Fillmore's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Mallory Fillmore was last updated on December 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 28, 2012PECOS EnrolledAccepts Medicare Assignment

93.57/100

CMS Quality Rating

3680 NW SAMARITAN DR, CORVALLIS, OR 97330(541) 754-1150 Get Directions Write a Review

NPPES record last updated: December 30, 2024. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Dec 30, 2024, Apr 28, 2021, Aug 16, 2018 and 1 more (4 updates tracked since 2017).

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About Mallory Fillmore Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MALLORY FILLMORE PA-C (NPI 1215272505) is an individual physician assistant in Corvallis, Oregon, licensed in Oregon (PA174128) and active in the NPI registry since November 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1215272505

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMALLORY FILLMORECredential: PA-C

Location Address3680 NW SAMARITAN DRCorvallis, OR 97330-3737

Mailing Address444 Nw Elks DrCorvallis, OR 97330-3745 · (541) 754-1150

Phone(541) 754-1150

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateNovember 28, 2012

Last NPPES UpdateDecember 30, 20244 updates tracked since enumeration

NPPES CertifiedDecember 30, 2024

✔ NPI 1215272505 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in OR · PA174128

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

3680 NW SAMARITAN DR, Corvallis, OR 97330

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Other Identifiers 1

Medicaid500695157OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mallory Fillmore Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2466697578

PECOS Enrollment IDI20151110001301

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

78 services78 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

42 services35 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

21 services19 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

18 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97330 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.82 typical visit price

range $54.96 – $166.64

Typical copayment $21.20 (range $13.74 – $41.66)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.68 – $136.19

Typical copayment $17.16 (range $4.42 – $34.04)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

93.57/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

85.33

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

99%223 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. LAURA LUCZKIW

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