NPIMap

Individual provider Active NPI

David G Mulder, DO

  • Internal Medicine Physician
  • Peabody, MA
National Provider Identifier
1174505507
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
231400 Issued in MA
Practice address
100 Brooksby Village Drive
Brooksby Medical Clinic
Peabody, MA 01960
Phone
(978) 536-7850
Fax
(877) 280-9727
NPI assigned
Nov 21, 2005
Last updated
Feb 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3466 IA
Internal Medicine Physician 207R00000X 231400 MA Primary

Addresses

Primary practice location

100 Brooksby Village Drive
Brooksby Medical Clinic
Peabody, MA 01960

Mailing address

5730 Executive Dr Ste 230
Catonsville, MD 21228-1762
Phone (978) 536-7850

Other identifiers 6

IdentifierTypeStateIssuer
522239464OtherTRICARE NORTH
0278101MedicaidIA
04-40166OtherEVERCARE
M20932MedicaidIA
31343OtherIAWELLMARK BCBS
1174505507OtherBCBS

Other names 1

  • None None Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070911000155 MA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 9830290394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Brooksby Village Dr
Peabody, MA 01960-1438
Phone (978) 536-7850

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3466IAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erickson Health Medical Group of Massachusetts PC Internal Medicine CurrentSince Apr 30, 2007 Accepting new patients
Erickson Health Medical Group of Massachusetts PC CurrentSince Apr 30, 2007 Accepting new patients
Pine Ridge Indian Health Service Hospital PastSince Sep 24, 2016 Accepting new patients

Locations

300 Linden Ponds Way
Hingham, MA 02043
Phone (781) 534-7100

100 Brooksby Village Dr
Peabody, MA 01960
Phone (978) 536-2150

5525 Research Park Dr
Fl 4
Catonsville, MD 21228
Phone (410) 247-5602

5730 Executive Dr
Ste 230
Catonsville, MD 21228
Phone (410) 402-2379

Organizations & group practices 3

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.

Hospital & facility affiliations 10

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1174505507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 EXECUTIVE DR STE 230",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212281762",
            "telephone_number": "978-536-7850",
            "fax_number": "978-536-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BROOKSBY VILLAGE DRIVE",
            "address_2": "BROOKSBY MEDICAL CLINIC",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "01960",
            "telephone_number": "978-536-7850",
            "fax_number": "877-280-9727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDER",
        "first_name": "DAVID",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "3466",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "231400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE NORTH",
            "identifier": "522239464",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0278101",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "04-40166",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M20932",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "31343",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1174505507",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NONE",
            "last_name": "NONE",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.