Individual provider Active NPI

Michael Joseph McNulty, M.D.

  • Pain Medicine Physician
  • New Hartford, NY
National Provider Identifier
1013177450
Registry record updated Aug 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
247093 Issued in NY
Practice address
1729 Burrstone Rd
New Hartford, NY 13413-1001
Phone
(315) 798-1747
Fax
(315) 798-1707
NPI assigned
Jun 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X 247093 NY Primary

Addresses

Primary practice location

1729 Burrstone Rd
New Hartford, NY 13413-1001

Mailing address

1729 Burrstone Rd
New Hartford, NY 13413-1001
Phone (315) 798-1747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090512000344 NY Practitioner - Pain Management 3072662576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Slocum Dickson Medical Group PLLCGroup PAC ID 5799778510, 79 clinicians

Practice addresses (Care Compare)

1729 Burrstone Rd
New Hartford, NY 13413-1001
Phone (315) 798-1500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
247093NYMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Slocum Dickson Medical Group PLLC CurrentSince Mar 15, 2012 Accepting new patients

Locations

1729 Burrstone Rd
New Hartford, NY 13413
Phone (315) 798-1500

Interoperability endpoints

  • Direct secure messaging: mmcnulty55768@mvhealthsystem.direct-ci.com

Organizations & group practices 1

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": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345766400000",
    "number": "1013177450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 BURRSTONE RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131001",
            "telephone_number": "315-798-1747",
            "fax_number": "315-798-1707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 BURRSTONE RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131001",
            "telephone_number": "315-798-1747",
            "fax_number": "315-798-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNULTY",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-10",
        "last_updated": "2012-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NY",
            "license": "247093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hartford, NY

Sources for this page

Verify at the official NPI Registry.