Individual provider Active NPI

Xavier Max Mortensen, MD

  • Ophthalmology Physician
  • Spokane, WA
National Provider Identifier
1881154987
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD61442740 Issued in WA
Practice address
427 S Bernard St
Spokane, WA 99204-2559
Phone
(509) 456-0107
Fax
(509) 747-2635
NPI assigned
Mar 23, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 01089469A IN
Ophthalmology Physician 207W00000X MD61442740 WA Primary

Addresses

Primary practice location

427 S Bernard St
Spokane, WA 99204-2559

Mailing address

427 S Bernard St
Spokane, WA 99204-2559
Phone (509) 456-0107

Other practice location 1

16201 E Indiana Ave Ste 5000
Spokane Valley, WA 99216-1883
Phone (509) 456-0107

Other practice location 2

31 E Central Ave
Spokane, WA 99208-1161
Phone (509) 456-0107

Other practice location 3

9651 N Nevada St
Spokane, WA 99218-1132
Phone (509) 456-0107

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240611001631 WA Practitioner - Ophthalmology 2062834716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Utah School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spokane Eye Clinic PSGroup PAC ID 1759278393, 36 clinicians

Practice addresses (Care Compare)

427 S Bernard St
Spokane, WA 99204-2509
Phone (509) 456-0107

Merit-based Incentive Payment System (MIPS)

Final score
90.64 of 100Reported as group
Quality
92.23
Promoting interoperability
100
Improvement activities
40
Cost
76.58

Merit-based Incentive Payment System (MIPS)

Final score
77.7 of 100Reported as group
Quality
74.71
Improvement activities
40
Cost
59.38

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01089469AINMDOphthalmology Physician
MD61442740WAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Retinal Consultants LLC Ophthalmology Current Accepting new patients
Spokane Eye Clinic PS Ophthalmology CurrentSince Jul 31, 2024 Accepting new patients
Spokane Eye Clinic PS Ophthalmology CurrentSince Jul 31, 2024 Accepting new patients
Spokane Eye Clinic PS Past Accepting new patients

Locations

31 E Central Ave
Spokane, WA 99208
Phone (509) 456-0107

427 S Bernard St
Ste 200
Spokane, WA 99204
Phone (509) 456-8150

9651 N Nevada St
Spokane, WA 99218
Phone (509) 363-2180

427 S Bernard St
Spokane, WA 99204
Phone (509) 456-0107

16201 E Indiana Ave
Ste 5000
Spokane Valley, WA 99216
Phone (509) 456-0107

Interoperability endpoints

  • Direct secure messaging: xmortensen@arcnj.intellechartdirect.net
  • Direct secure messaging: xavier.mortensen.p2@direct.spokaneeye.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1553299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1881154987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 S BERNARD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042559",
            "telephone_number": "509-456-0107",
            "fax_number": "509-747-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 S BERNARD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042559",
            "telephone_number": "509-456-0107",
            "fax_number": "509-747-2635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16201 E Indiana Ave Ste 5000",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992161883",
            "country_code": "US",
            "telephone_number": "509-456-0107",
            "fax_number": "509-747-2635",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31 E Central Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992081161",
            "country_code": "US",
            "telephone_number": "509-456-0107",
            "fax_number": "509-747-2635",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9651 N Nevada St",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992181132",
            "country_code": "US",
            "telephone_number": "509-456-0107",
            "fax_number": "509-747-2635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "XAVIER",
        "middle_name": "MAX",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-23",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01089469A",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD61442740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.