Active NPI
Steven Paul Mullins, O.D.
- Optometrist
- Medford, OR
National Provider Identifier
1164589230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1603T
- Practice address
- 1740 Delta Waters Rd
Suite 100
Medford, OR 97504-9175 - Phone
- (541) 245-6856
- Fax
- (541) 245-0734
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1603T | OR | Primary |
Addresses
Primary practice location
1740 Delta Waters Rd
Suite 100
Medford, OR 97504-9175
Mailing address
1740 Delta Waters Rd
Suite 100
Medford, OR 97504-9175
Phone (541) 245-6856
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 226305 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051130000911 | OR | Practitioner - Optometry | 3375563711 | Practice locations: Medford, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern California College of Optometry, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1740 Delta Waters Rd
Suite 100
Medford, OR 97504-9175
Phone (541) 245-6856
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 48 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1603 | OR | MD | Clinical Psychologist |
| 1603T | OR | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235952000000",
"number": "1164589230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1740 DELTA WATERS RD",
"address_2": "SUITE 100",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975049175",
"telephone_number": "541-245-6856",
"fax_number": "541-245-0734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 DELTA WATERS RD",
"address_2": "SUITE 100",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975049175",
"telephone_number": "541-245-6856",
"fax_number": "541-245-0734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLINS",
"first_name": "STEVEN",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-02",
"last_updated": "2009-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "1603T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "226305",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.