Individual provider Active NPI

William R Mullen, PA-C

  • Physician Assistant
  • Concord, NH
National Provider Identifier
1144255373
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0507 Issued in NH
Practice address
264 Pleasant St
Concord, NH 03301-2551
Phone
(603) 224-3368
Fax
(603) 228-7268
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0507 NH
Physician Assistant 363A00000X 0507 NH Primary

Addresses

Primary practice location

264 Pleasant St
Concord, NH 03301-2551

Mailing address

264 Pleasant St
Concord, NH 03301-2551
Phone (603) 224-3368

Other practice location 1

718 Smyth Rd
Manchester, NH 03104-4098
Phone (603) 624-4366 ext. 2228

Other identifiers 7

IdentifierTypeStateIssuer
30333016MedicaidNH
1861558645OtherNHNSC PROVIDER LOCATION #
1841320207OtherNHNSC PROVIDER LOCATION #
1922164797OtherNHNSC PROVIDER LOCATION #
1881772242OtherNHNSC PROVIDER LOCATION #
1932256914OtherNHNSC PROVIDER LOCATION #
1801952692OtherNSC PROVIDER LOCATION #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20040903000567 NH Practitioner - Physician Assistant 4587630298 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0507NHMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Orthopaedic Alliance PLLC Orthopaedic Surgery CurrentSince Apr 2, 2025 Accepting new patients
Concord Orthopaedics Professional Association Orthopaedic Surgery CurrentSince Apr 4, 2011 Accepting new patients
Concord Orthopaedics Professional Association Orthopaedic Surgery CurrentSince Apr 4, 2011 Accepting new patients

Locations

264 Pleasant St
Concord, NH 03301

6 Tsienneto Rd
Ste 200
Derry, NH 03038
Phone (603) 426-5222

41 Buttrick Rd
Londonderry, NH 03053
Phone (603) 422-8693

17 Riverside St
Ste 101
Nashua, NH 03062
Phone (603) 689-1690

103 Boulder Point Dr
Plymouth, NH 03264
Phone (603) 536-1284

Interoperability endpoints

  • Direct secure messaging: william.mullen.1@32845.direct.athenahealth.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1144255373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012551",
            "telephone_number": "603-224-3368",
            "fax_number": "603-228-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012551",
            "telephone_number": "603-224-3368",
            "fax_number": "603-228-7268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "718 Smyth Rd",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031044098",
            "country_code": "US",
            "telephone_number": "603-624-4366 x2228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NH",
            "license": "0507",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30333016",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC PROVIDER LOCATION #",
            "identifier": "1861558645",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC PROVIDER LOCATION #",
            "identifier": "1841320207",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC PROVIDER LOCATION #",
            "identifier": "1922164797",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC PROVIDER LOCATION #",
            "identifier": "1881772242",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC PROVIDER LOCATION #",
            "identifier": "1932256914",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC PROVIDER LOCATION #",
            "identifier": "1801952692",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.