PAUL DAVID MORTLOCK PA-C
NPI 1376506733
Physician Assistant - Medical in Vancouver, WA

Q: What is Paul Mortlock's NPI number?

The NPI number for Paul Mortlock is 1376506733. It was assigned to this individual provider in the NPPES registry on April 7, 2006.

Q: What is Paul Mortlock's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Paul Mortlock was last updated on August 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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 April 07, 2006PECOS EnrolledAccepts Medicare Assignment

400 NE MOTHER JOSEPH PL, VANCOUVER, WA 98664(360) 892-9664(360) 892-9667 Get Directions Write a Review

NPPES record last updated: August 29, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 17, 2018, Nov 17, 2017 (2 updates tracked since 2017).

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About Paul David Mortlock Pa-c NPPES

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

PAUL DAVID MORTLOCK PA-C (NPI 1376506733) is an individual medical provider in Vancouver, Washington, licensed in Washington (PA10004695) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Peacehealth St John Medical Center, and maintains a secondary practice location in Vancouver.

NPPES Registry Identity

NPI1376506733

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NamePAUL DAVID MORTLOCKCredential: PA-C

Location Address400 NE MOTHER JOSEPH PLVancouver, WA 98664-3200

Mailing Address19020 33rd Ave W Ste 210Lynnwood, WA 98036-4748 · (425) 563-1500 · Fax (425) 563-1374

Phone(360) 892-9664

Fax(360) 892-9667

Sole ProprietorNo

Medical School CMSOtherGraduated 2004

Enumeration DateApril 7, 2006

Last NPPES UpdateAugust 29, 20242 updates tracked since enumeration

NPPES CertifiedAugust 29, 2024

✔ NPI 1376506733 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in WA · PA10004695

Also ListedPhysician AssistantTaxonomy 363A00000X · License PA10004695 (WA)

400 NE MOTHER JOSEPH PL, Vancouver, WA 98664

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Secondary Practice Location 1

Location 12101 NE 139th St Ste 380Vancouver, WA 98686-2309 · Phone (360) 487-1888

Other Identifiers 2

Medicaid807410400ID

Medicaid8418188WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.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

Paul David Mortlock 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 ID9234179326

PECOS Enrollment IDI20050509000382

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 8

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.

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

55 services54 patients

Review by radiologist of ct guidance for needle placement 77012

This process involves a radiologist examining CT scan images to accurately guide a needle's placement within the body. This technique is often used for biopsies or treatments, ensuring precision and safety.

29 services29 patients

Fine needle aspiration biopsy using ultrasound guidance, first growth 10005

Fine needle aspiration biopsy with ultrasound guidance is a procedure where a thin needle is inserted into a growth to extract a small sample. Ultrasound helps accurately locate the growth. This sample is then analyzed to determine the nature of the growth.

22 services22 patients

Aspiration of fluid from chest cavity using imaging guidance 32555

This procedure, known as a thoracentesis, involves removing fluid from the space between the lungs and chest wall, called the pleural space. It's performed under imaging guidance to ensure precision. It can help diagnose conditions or relieve symptoms like shortness of breath.

22 services20 patients

Drainage of fluid from abdominal cavity using imaging guidance 49083

This procedure involves removing excess fluid from your abdominal cavity, which can relieve discomfort. A specialist uses imaging technology to guide a thin needle into the right spot. The fluid is then drained out safely.

19 services13 patients

Fluoroscopic guidance for insertion or removal of central vein access device 77001

Fluoroscopic guidance for central vein access device insertion or removal is a procedure where a special X-ray, called a fluoroscope, is used to help accurately place or remove a device in a central vein. This device aids in delivering medications or collecting blood samples.

18 services18 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Peacehealth St John Medical Center

Acute Care Hospitals · Longview, WA

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number500041

Location1615 Delaware StreetLongview, WA 98632 · Cowlitz County

Emergency services Birthing friendly

Peacehealth Southwest Medical Center

Acute Care Hospitals · Vancouver, WA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500050

Location400 NE Mother Joseph PlaceVancouver, WA 98668 · Clark County

Emergency services Birthing friendly

Legacy Salmon Creek Medical Center

Acute Care Hospitals · Vancouver, WA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500150

Location2211 NE 139th StreetVancouver, WA 98686 · Clark County

Emergency services Birthing friendly

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.

Reported Quality Measures

Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques

Percentage of final reports for patients aged 18 years and older undergoing CT with documentation that one or more of the following dose reduction techniques were used: - Automated exposure control - Adjustment of the mA and/or kV according to patient size -…

85%163 patients

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.

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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.

DR. TYLER JUSTIN PARADIS MD

Anesthesiology