Individual provider Active NPI

Micah N. Mohler, PA-C

  • Surgical Physician Assistant
  • Issaquah, WA
National Provider Identifier
1720480254
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60504937 Issued in WA
Practice address
510 8TH Ave NE Ste 200
Issaquah, WA 98029-5436
Phone
(425) 392-3030
Fax
(425) 392-2564
NPI assigned
Sep 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60504937 WA
Surgical Physician Assistant 363AS0400X PA60504937 WA Primary

Addresses

Primary practice location

510 8TH Ave NE Ste 200
Issaquah, WA 98029-5436

Mailing address

510 8TH Ave NE Ste 320
Issaquah, WA 98029-5436
Phone (425) 507-0733

Other practice location 1

3101 Northup Way Ste 201
Bellevue, WA 98004-1449
Phone (425) 455-3600

Other practice location 2

515 Minor Ave Ste 200
Seattle, WA 98104-2133
Phone (425) 455-3600

Other practice location 3

18100 NE Union Hill Rd Ste 330
Redmond, WA 98052-3330
Phone (425) 455-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20141028001025 WA Practitioner - Physician Assistant 1153542592 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

18100 NE Union Hill Rd
Redmond, WA 98052-3330
Phone (425) 498-2345

3101 Northup Way
Bellevue, WA 98004-1449

510 8TH Ave NE
Issaquah, WA 98029-5436

751 NE Blakely Dr
Issaquah, WA 98029-6201
Phone (425) 313-5422

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons, Inc., P.S. CurrentSince Oct 13, 2014 Accepting new patients
Proliance Surgeons Inc P S Surgical CurrentSince Oct 13, 2014 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 6, 2020 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 6, 2020 Accepting new patients

Locations

3101 Northup Way
Ste 201
Bellevue, WA 98004
Phone (425) 455-3600

11511 NE 10th St
Hunts Point, WA 98004
Phone (425) 502-3000

510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030

12911 120th Ave NE
Ste H120
Kirkland, WA 98034
Phone (425) 823-4226

18100 NE Union Hill Rd
Ste 330
Redmond, WA 98052
Phone (425) 392-3030

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

515 Minor Ave
Ste 200
Seattle, WA 98104
Phone (206) 386-9615

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1720480254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 320",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-507-0733",
            "fax_number": "425-283-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 200",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-392-3030",
            "fax_number": "425-392-2564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3101 Northup Way Ste 201",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980041449",
            "country_code": "US",
            "telephone_number": "425-455-3600",
            "fax_number": "425-455-3920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Minor Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981042133",
            "country_code": "US",
            "telephone_number": "425-455-3600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18100 NE Union Hill Rd Ste 330",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "WA",
            "postal_code": "980523330",
            "country_code": "US",
            "telephone_number": "425-455-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHLER",
        "first_name": "MICAH",
        "middle_name": "N.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-16",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60504937",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60504937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.