Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Marty Jay Mortimer, PA-C

Individual provider Physician Assistant · NPI 1689732810

Marty Jay Mortimer, PA-C is a Physician Assistant in Rockford, Michigan. Qualified in 2002, 24 years ago. Practices with Spectrum Health United, a 88-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
24
Licensed in
MI
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

8501 Meadow Crk
Rockford, MI 49341-7524
Phone: (616) 267-7884
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601006939 (MI)

Record details

NPI number1689732810
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 4, 2006
Last updated in NPPESFebruary 18, 2021
Certification dateFebruary 18, 2021
Mailing address100 Michigan St Ne # Mc845, Grand Rapids, MI 49503-2560

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Spectrum Health United — 88 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

Other providers in Rockford