Individual provider Active NPI

Lisa M Mullins, FNP-C

  • Nurse Practitioner
  • Binghamton, NY
National Provider Identifier
1194819235
Registry record updated Nov 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
331696 Issued in NY
Practice address
161 Riverside Dr
Suite 109
Binghamton, NY 13905-4176
Phone
(607) 770-7074
Fax
(607) 770-3452
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 331696 NY Primary

Addresses

Primary practice location

161 Riverside Dr
Suite 109
Binghamton, NY 13905-4176

Mailing address

161 Riverside Dr
Suite 109
Binghamton, NY 13905-4176
Phone (607) 770-7074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20081113000096 NY Practitioner - Nurse Practitioner 2466511944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
331696NYMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allara Medical Group PA PastSince Jan 14, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lisa.mullins@335000925634564.direct.elationemr.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227571200000",
    "number": "1194819235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 RIVERSIDE DR",
            "address_2": "SUITE 109",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054176",
            "telephone_number": "607-770-7074",
            "fax_number": "607-770-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 RIVERSIDE DR",
            "address_2": "SUITE 109",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054176",
            "telephone_number": "607-770-7074",
            "fax_number": "607-770-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "331696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.