Mallory Marie McNicholas Dotson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA01405 Issued in OR

Practice address

10000 SE Main St
Suite 112
Portland, OR 97216-2448

Phone

(503) 255-3054

Fax

(503) 255-7651

NPI assigned

Oct 21, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mallory Marie McNicholas Former name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Portland Adventist Medical CenterGroup PAC ID 3274908819, 273 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Portland Hospital, Portland, OR, CCN 380060
• Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

Merit-based Incentive Payment System (MIPS)

Final score

92 of 100Reported as group

Quality

84.7

Promoting interoperability

100

Improvement activities

40

Cost

79.21

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdotson154421@direct.ohsu.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Portland Adventist Medical Center

  • Family Medicine Physician
  • Portland, OR
  • NPI 1750091021
  Medicare reassignment Care Compare group NPD
• Portland Adventist Medical Center

  • Family Medicine Physician
  • Portland, OR
  • NPI 1215910302
  Medicare reassignment
• Portland Adventist Medical Center

  • Emergency Medical Services (Emergency Medicine) Physician
  • Portland, OR
  • NPI 1316502719
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Oregon Health & Science University

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1609824010
  Care Compare affiliation
• Portland Adventist Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1801887658
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1114179116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST",
            "address_2": "SUITE 112",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162448",
            "telephone_number": "503-255-3054",
            "fax_number": "503-255-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 SE MAIN ST",
            "address_2": "SUITE 112",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972162448",
            "telephone_number": "503-255-3054",
            "fax_number": "503-255-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTSON",
        "first_name": "MALLORY",
        "middle_name": "MARIE MCNICHOLAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA01405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "MCNICHOLAS",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Willow Roseann Doss
• Christopher Sean Henry Dossett
• Benjamin James Dossetter, MD
• Elizabeth Doster, RN
• Lydia Elva Dotsey-Lewis
• Suzanne Elice Dotson, PA-C
• Laurie Dotten, MSW
• Elizabeth Doty, L.M.T.
• Nora J Doty, MD
• Roscoe Doty

• Medical Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.