Individual provider Active NPI

Jeffrey G Mulhern, MD

  • Nephrology Physician
  • West Springfield, MA
National Provider Identifier
1063402105
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
55789 Issued in MA
Practice address
134 Capital Dr Ste E
West Springfield, MA 01089-1320
Phone
(413) 733-0010
Fax
(413) 930-2108
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 035565 CT
Nephrology Physician 207RN0300X 55789 MA Primary

Addresses

Primary practice location

134 Capital Dr Ste E
West Springfield, MA 01089-1320

Mailing address

PO Box 366
Ludlow, MA 01056-0366
Phone (413) 733-0010

Other practice location 1

377 Research Pkwy
Meriden, CT 06450-7155
Phone (860) 265-6521

Other identifiers 2

IdentifierTypeStateIssuer
003089150MedicaidCT
110048323AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050509000870 MA Practitioner - Nephrology 6002809548 Reassigns benefits to 2 organizations
I20120123000751 CT Practitioner - Nephrology 6002809548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kidney Care and Transplant Services of New England PCGroup PAC ID 1658655352, 13 clinicians

Practice addresses (Care Compare)

201 Chestnut Hill Rd
Stafford Springs, CT 06076-4005
Phone (860) 265-6521

208 Ashley Ave
West Springfield, MA 01089-1353
Phone (413) 733-0010

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035565CTMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Care and Transplant Services of New England, PC Nephrology CurrentSince Feb 1, 2017 Accepting new patients
Baystate Medical Practices, Inc CurrentSince May 7, 1988 Accepting new patients
Riverbend Medical Group, Inc Past Accepting new patients

Locations

701 Enfield St
Ste 160
Enfield, CT 06082
Phone (860) 749-5975

113 Elm St
Enfield, CT 06082
Phone (860) 253-5196

201 Chestnut Hill Rd
Stafford Springs, CT 06076
Phone (860) 265-6521

115 Wildwood Ave
Greenfield, MA 01301
Phone (413) 773-0001

40 Wright St
Palmer, MA 01069
Phone (413) 284-5210

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

300 Birnie Ave
Springfield, MA 01107
Phone (413) 736-5649

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

100 Wason Ave
Ste 200
Springfield, MA 01107
Phone (413) 773-5797

2150 Main St
Springfield, MA 01104
Phone (413) 739-5676

300 Birnie Ave
Ste 300
Springfield, MA 01107

208 Ashley Ave
West Springfield, MA 01089
Phone (413) 747-4170

134 Capital Dr
Ste E
West Springfield, MA 01089

Interoperability endpoints

  • Direct secure messaging: jmulhern18686@direct.acumenmd.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1063402105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 366",
            "city": "LUDLOW",
            "state": "MA",
            "postal_code": "010560366",
            "telephone_number": "413-733-0010",
            "fax_number": "413-930-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 CAPITAL DR STE E",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010891320",
            "telephone_number": "413-733-0010",
            "fax_number": "413-930-2108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "377 Research Pkwy",
            "address_purpose": "LOCATION",
            "city": "Meriden",
            "state": "CT",
            "postal_code": "064507155",
            "country_code": "US",
            "telephone_number": "860-265-6521",
            "fax_number": "413-417-2978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULHERN",
        "first_name": "JEFFREY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CT",
            "license": "035565",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MA",
            "license": "55789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003089150",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110048323A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Springfield, MA

Sources for this page

Verify at the official NPI Registry.