Michael Patrick McMullen, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

163485 Issued in NY

Practice address

505 Beahan Rd
Rochester, NY 14624-3403

Phone

(585) 426-1470

Fax

(585) 426-6510

NPI assigned

Apr 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 7

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Soh Skin & Surgery, PLLC

  • MOHS-Micrographic Surgery Physician
  • Rochester, NY
  • NPI 1760154090
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258675200000",
    "number": "1073575429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 MELWOOD DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264510",
            "telephone_number": "585-453-0419",
            "fax_number": "585-453-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 BEAHAN RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146243403",
            "telephone_number": "585-426-1470",
            "fax_number": "585-426-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2009-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "163485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER #",
            "identifier": "1573",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01089129",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "5008322",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE PROVIDER",
            "identifier": "BF101110",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PAYEE ID",
            "identifier": "P010163485",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE #",
            "identifier": "MM31444B",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NOW PROVIDER #",
            "identifier": "000911507002",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott McMorris
• Christie Marie McMorrow, MD
• Ann McMullen
• Brett Alexander McMullen, PA
• Marilyn McMullen
• Shallie McMullen, LPN
• Karen A. McMurtry, N.P.
• Montiyah McMurty
• Brenda McNair, LPN
• Johnny Edward McNair II

• Family Medicine Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.