Individual provider Active NPI

Daniel G Mussen, PA-C

  • Physician Assistant
  • Glastonbury, CT
National Provider Identifier
1114939485
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
000002 Issued in CT
Practice address
320 Western Blvd.
Glastonbury, CT 06033-1053
Phone
(860) 568-9180
Fax
(860) 633-1793
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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 000002 CT Primary

Addresses

Primary practice location

320 Western Blvd.
Glastonbury, CT 06033-1053

Mailing address

4 Farm Springs Rd
Prohealth Physicians
Farmington, CT 06032-2573
Phone (860) 284-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050215000559 CT Practitioner - Physician Assistant 9436101722 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000002CTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Care Medical Group, PC Past Accepting new patients
Collins Medical Associates 2 PC Physician Assistant Past Accepting new patients
Prohealth Physicians, Inc. Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: daniel.mussen.npi1114939485.phpct@direct.optumcare.masshiway.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1114939485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FARM SPRINGS RD",
            "address_2": "PROHEALTH PHYSICIANS",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322573",
            "telephone_number": "860-284-5200",
            "fax_number": "860-284-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WESTERN BLVD.",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331053",
            "telephone_number": "860-568-9180",
            "fax_number": "860-633-1793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSSEN",
        "first_name": "DANIEL",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "000002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

Verify at the official NPI Registry.