Individual provider Active NPI

Melea Lenore Mullican, PA-C

  • Physician Assistant
  • Decatur, AL
National Provider Identifier
1114557030
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1585 Issued in AL
Practice address
1107 14TH Ave SE Ste 200
Decatur, AL 35601-3354
Phone
(256) 705-4224
Fax
(256) 705-4135
NPI assigned
Jan 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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 1585 AL Primary

Addresses

Primary practice location

1107 14TH Ave SE Ste 200
Decatur, AL 35601-3354

Mailing address

PO Box 18428
Huntsville, AL 35804-8428
Phone (256) 705-4224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20200918001253 AL Practitioner - Physician Assistant 1658799952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oncology Specialties, P.C.Group PAC ID 1254328495, 108 clinicians

Practice addresses (Care Compare)

3601 Cci Dr
Huntsville, AL 35805-0001
Phone (256) 327-5905

3601 Cci Dr
Huntsville, AL 35805-2606

3601 Cci Dr NW
Huntsville, AL 35805-2606
Phone (256) 705-4224

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1585ALMDMental Health Counselor

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.

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": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1114557030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18428",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358048428",
            "telephone_number": "256-705-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 14TH AVE SE STE 200",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356013354",
            "telephone_number": "256-705-4224",
            "fax_number": "256-705-4135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLICAN",
        "first_name": "MELEA",
        "middle_name": "LENORE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-20",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "1585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

Verify at the official NPI Registry.