Individual provider Active NPI

Anne Caitlin McMullen, NP

  • Nurse Practitioner
  • Stanford, CA
National Provider Identifier
1174090161
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95010249 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Oct 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95168710 CA
Nurse Practitioner 363L00000X 95010249 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Other identifiers 1

IdentifierTypeStateIssuer
NP9501024OtherCAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190820001254 CA Practitioner - Nurse Practitioner 6507194230 Reassigns benefits to 4 organizations
I20251001001918 MA Practitioner - Nurse Practitioner 6507194230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cardiovascular Center at Tufts Medical Center IncGroup PAC ID 3870857816, 98 clinicians

Practice addresses (Care Compare)

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95168710CAMDRegistered Nurse
95010249CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Center at Tufts Medical Center, Inc. CurrentSince Oct 27, 2025 Accepting new patients
Sansum Clinic CurrentSince Jan 22, 2020 Accepting new patients
Sansum Clinic CurrentSince Jan 22, 2020 Accepting new patients
Sansum Clinic Current Accepting new patients
Cep America - California Current Accepting new patients
Cep America - California CurrentSince Aug 25, 2019 Accepting new patients
County of San Mateo CurrentSince Jun 15, 2019 Accepting new patients
County of San Mateo CurrentSince Jun 15, 2019 Accepting new patients
Cep America-California CurrentSince Aug 25, 2019 Accepting new patients
Stanford Health Care Current Accepting new patients
County of San Mateo CurrentSince Jun 15, 2019 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

170 Alameda de las Pulgas
Redwood City, CA 94062
Phone (650) 367-5536

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

317 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 681-7500

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

800 Washington St
#1
Boston, MA 02111

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

Organizations & group practices 11

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": "1540598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1174090161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "ANNE",
        "middle_name": "CAITLIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-27",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95168710",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95010249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "NP9501024",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.