Carolina Alexandra Van Tulder, PA-C
NPI 1417433145ActiveIndividual· Physician Assistant· Tigard, OR
Physician Assistant (PA-C) with Mountain West Derm - Blackhart PLLC, practicing in Tigard, Oregon. 362 Medicare patients in 2024, $60,006 paid; nearly all of their 493 Part D prescriptions were generic (97%). Ucb, Inc. was the largest of 2 companies reporting payments in 2024, $63.74 in all, mostly food and beverage. Lists Ohsu Hospital and Clinics as a hospital affiliation.
Overview
| NPI | 1417433145 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Jul 16, 2018 |
| Last updated in NPPES | Apr 15, 2025 |
| Certified by provider | Apr 15, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | PA214771 | OR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (OR); Practitioner - Physician Assistant (SC) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 362 |
|---|---|
| Services billed | 1,586 across 42 procedure codes |
| Paid by Medicare | $60,006 |
Part D prescriptions in 2024
| Prescriptions (claims) | 493 · 596 30-day fills |
|---|---|
| Patients | 260 |
| Total drug cost | $70,031 |
| Generic share | 97% of claims |
Education and affiliations
| Graduation year | 2018 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Mountain West Derm - Blackhart PLLCTigard, OR · 105 clinicians
Hospital affiliation
- Ohsu Hospital and ClinicsPortland, OR
Industry payments (Open Payments)
- 2024$63.74 · 2 payments from 2 companies
Top paying companies in 2024
| Company | Amount | Payments |
|---|---|---|
| Ucb, Inc. | $32.73 | 1 |
| Lilly USA, LLC | $31.01 | 1 |
What the 2024 payments were for
- Food and Beverage$63.74 · 2 payments
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 50 physician assistants in Tigard · All physician assistants in Oregon