Individual provider Active NPI

Patricia Chu Mulder, PA

  • Physician Assistant
  • Marietta, GA
National Provider Identifier
1063832749
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
790 Church St NE Ste 400
Marietta, GA 30060-8957
Phone
(770) 405-2976
NPI assigned
Apr 22, 2014
Last updated
Nov 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

790 Church St NE Ste 400
Marietta, GA 30060-8957

Mailing address

PO Box 3157
Indianapolis, IN 46206-3157
Phone (770) 405-2976

Other practice location 1

818 Church St NE
Marietta, GA 30060-8981
Phone (770) 590-4190

Other practice location 2

2639 Morgan Lake Dr NE
Marietta, GA 30066-5611
Phone (786) 925-7385

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pmulder110515@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20151002002372 GA Practitioner - Physician Assistant 2567682420 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians
Quantum Radiology PCGroup PAC ID 4385543230, 105 clinicians

Practice addresses (Care Compare)

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4022

4282 Bells Ferry Rd NW
Kennesaw, GA 30144-1302
Phone (678) 701-4125

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

789 Church St NE
Suite 200
Marietta, GA 30060-7238
Phone (770) 881-7964

790 Church St NE
Suite 400
Marietta, GA 30060-8957
Phone (770) 952-8899

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2106SCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince Sep 15, 2023 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Jan 1, 2021 Accepting new patients
Quantum Radiology, PC CurrentSince Nov 1, 2025 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Jan 1, 2021 Accepting new patients
Tuomey Past Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients
Mount Lassen Emergency Physicians LLC Past Accepting new patients
Lavender Inpatient Services LLC Past Accepting new patients

Locations

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

8954 Hospital Dr
Douglasville, GA 30134
Phone (678) 838-2584

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (470) 644-7000

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

2540 Windy Hill Rd SE
Marietta, GA 30067
Phone (470) 644-1274

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

790 Church St NE
Ste 400
Marietta, GA 30060
Phone (770) 405-2976

818 Church St NE
Marietta, GA 30060
Phone (770) 590-4190

3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500

Organizations & group practices 10

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 2

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": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1063832749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3157",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063157",
            "telephone_number": "770-405-2976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 CHURCH ST NE STE 400",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608957",
            "telephone_number": "770-405-2976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "818 Church St NE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300608981",
            "country_code": "US",
            "telephone_number": "770-590-4190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2639 Morgan Lake Dr NE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300665611",
            "country_code": "US",
            "telephone_number": "786-925-7385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULDER",
        "first_name": "PATRICIA",
        "middle_name": "CHU",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmulder110515@directwellstar.org",
            "affiliation": "N",
            "address_1": "818 Church St NE",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300608981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.