Kevin McMullen, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A142278 Issued in CA

Practice address

1821 South Ave W Ste 402
Missoula, MT 59801-6518

Phone

(406) 543-8512

Fax

(406) 541-8513

NPI assigned

Jun 18, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Massachusetts Medical School, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Medical Center Hospital, Missoula, MT, CCN 270023
• St. Patrick Hospital Hospital, Missoula, MT, CCN 270014

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.mcmullen@forefrontdermatology.emadirect.md
• Direct secure messaging: kmccmullen@directaddress.net

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.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Missoula, MT
  • NPI 1922647395
  Medicare reassignment Care Compare group NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services Mt

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1023032588
  Care Compare affiliation
• Providence Health & Services Mt

  • Medical Oncology Physician
  • Missoula, MT
  • NPI 1326483587

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  • Anatomic Pathology & Clinical Pathology Physician
  • Missoula, MT
  • NPI 1366185928

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  • Psychiatric Hospital Unit
  • Missoula, MT
  • NPI 1619058302
  Care Compare affiliation
• RCHP Billings - Missoula LLC

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1346642899
  Care Compare affiliation

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1225442247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK S T",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "206-639-0089",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 SOUTH AVE W STE 402",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016518",
            "telephone_number": "406-543-8512",
            "fax_number": "406-541-8513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Amsden St",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "MA",
            "postal_code": "024745502",
            "country_code": "US",
            "telephone_number": "617-775-4434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Daniel Burnham Ct Ste 305C",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941090466",
            "country_code": "US",
            "telephone_number": "415-771-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2875 Tina Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598081582",
            "country_code": "US",
            "telephone_number": "406-613-7676",
            "fax_number": "406-206-6316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-18",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A142278",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "260111",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kevin.McMullen@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1821 South Ave W Ste 402",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598016518",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kevin.McMullen@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "2875 Tina Ave Ste 104",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598081582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacqueline Rose McMahon, CNM
• Julie McMahon, RNP
• Jeff Rion McMaster, RPH.
• David McMeekin, PA-C
• Rebeccah Tye McMillan, PT
• Shannon McNabb, LCPC
• Elizabeth A. McNeece, PA-C
• Jonathan Warren McNeely, M.D.
• Sarah J McNerney, FNP
• Colleen Marie McNulty, LAC

• Dermatology Physician in Missoula, MT
• Providers in Missoula, MT by specialty
• Dermatology Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.

Verify at the official NPI Registry.