Tyson John McMullen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA63707 Issued in CA

Practice address

1360 Walden Rd
Walnut Creek, CA 94597-3158

Phone

(925) 324-1116

NPI assigned

Jun 20, 2023

Last updated

Jul 23, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Ca Pacs 2 Medical Group Inc

  • Hospitalist Physician
  • San Leandro, CA
  • NPI 1801372669
  Medicare reassignment
• California Post-Acute Medical Group 1, Inc.

  • Hospitalist Physician
  • Alameda, CA
  • NPI 1265971949
  Medicare reassignment
• CS Pacs 3 Ca Medical Group Inc

  • Internal Medicine Physician
  • Mountain View, CA
  • NPI 1922775360
  Medicare reassignment

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1154006757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 WALDEN RD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945973158",
            "telephone_number": "925-324-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 WALDEN RD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945973158",
            "telephone_number": "925-324-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "TYSON",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-20",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA63707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Jean McMenamy, LCSW
• Brim Aaron McMillan-Gordon, DPM
• Raechal Brooks McMillan, AU.D
• Damion McMiller
• Kai Jada McMillian
• Shantelle Lynette McNabb
• Kristina Kelley McNaught, PA-C
• Tricia Ruth McNeal, AGNP
• Tamera Yvette McNeil, OTR/L
• William McNeil

• Physician Assistant in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.