Individual provider Active NPI

Lori H. Mulick, NP

  • Women's Health Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1003100074
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP7256 Issued in AZ
Practice address
6565 E. Carondelet
Ste. 300
Tucson, AZ 85710
Phone
(520) 323-0333
Fax
(520) 323-5036
NPI assigned
Jun 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN085419 AZ
Women's Health Nurse Practitioner 363LW0102X AP7256 AZ Primary

Addresses

Primary practice location

6565 E. Carondelet
Ste. 300
Tucson, AZ 85710

Mailing address

5550 E Hampton St
Tucson, AZ 85712-2919
Phone (520) 721-8605

Other identifiers 1

IdentifierTypeStateIssuer
138059MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20200514002276 AZ Practitioner - Nurse Practitioner 7113358797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMC Medical NetworkGroup PAC ID 9638457013, 276 clinicians

Practice addresses (Care Compare)

5550 E Hampton St
Tucson, AZ 85712-2919
Phone (520) 420-2260

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN085419AZMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Medical Network CurrentSince Apr 1, 2024 Accepting new patients
Genesis OB GYN PLLC Past Accepting new patients

Locations

4881 E Grant Rd
Tucson, AZ 85712
Phone (520) 829-6776

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

5550 E Hampton St
Tucson, AZ 85712
Phone (520) 420-2260

Networks

  • NM HMO C-SNP

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19050/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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 1

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": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1003100074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5550 E HAMPTON ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122919",
            "telephone_number": "520-721-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 E. CARONDELET",
            "address_2": "STE. 300",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85710",
            "telephone_number": "520-323-0333",
            "fax_number": "520-323-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULICK",
        "first_name": "LORI",
        "middle_name": "H.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN085419",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "AP7256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138059",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.