Individual provider Active NPI

Mary Susan McMullen, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1194301614
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP021506 Issued in PA
Practice address
3998 Red Lion Rd Ste 214
Philadelphia, PA 19114-1440
Phone
(215) 612-5050
NPI assigned
Mar 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP021506 PA Primary

Addresses

Primary practice location

3998 Red Lion Rd Ste 214
Philadelphia, PA 19114-1440

Mailing address

1816 Gibson Rd
Bensalem, PA 19020-3010
Phone (215) 499-8074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210420000009 PA Practitioner - Nurse Practitioner 4981012614 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Practice addresses (Care Compare)

3998 Red Lion Rd
Philadelphia, PA 19114-1440

5000 Frankford Ave
Philadelphia, PA 19124-2620

535 S Oxford Valley Rd
Fairless Hills, PA 19030-2612
Phone (215) 946-3100

65 Newtown Richboro Rd
Alterra Wynewood at Northampton
Richboro, PA 19047
Phone (215) 357-6565

Hospital & facility affiliations

  • Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc CurrentSince Aug 23, 2022 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Aug 23, 2022 Accepting new patients
Aria Health Physician Services CurrentSince Mar 9, 2021 Accepting new patients
Aria Health Physician Services Current Accepting new patients
Aria Health Physician Services CurrentSince Mar 9, 2021 Accepting new patients

Locations

380 N Oxford Valley Rd
Langhorne, PA 19047
Phone (215) 949-5000

3998 Red Lion Rd
Philadelphia, PA 19114
Phone (215) 612-4060

3998 Red Lion Rd
Ste 214
Philadelphia, PA 19114
Phone (215) 612-5050

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

5000 Frankford Ave
Ste 1B
Philadelphia, PA 19124
Phone (215) 583-2355

Organizations & group practices 5

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1194301614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 GIBSON RD",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190203010",
            "telephone_number": "215-499-8074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 RED LION RD STE 214",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141440",
            "telephone_number": "215-612-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "MARY",
        "middle_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP021506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.