Individual provider Active NPI

David A Mulder, PA

  • Physician Assistant
  • Midland, MI
National Provider Identifier
1245338326
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
DM004328 Issued in MI
Practice address
4005 Orchard
Midland, MI 48640
Phone
(989) 839-3515
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X DM004328 MI Primary

Addresses

Primary practice location

4005 Orchard
Midland, MI 48640

Mailing address

4005 Orchard
Midland, MI 48640
Phone (989) 839-3515

Other identifiers 1

IdentifierTypeStateIssuer
Q22729OtherMIUPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040910000317 MI Practitioner - Physician Assistant 5597732503 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

4500 Campus Ridge Dr
Midland, MI 48640-6123
Phone (989) 837-9250

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
DM004328MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland CurrentSince Jul 1, 2007 Accepting new patients
Mymichigan Medical Center Gladwin CurrentSince Mar 13, 2021 Accepting new patients
Mymichigan Medical Center Alma CurrentSince Mar 2, 2021 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Jul 1, 2007 Accepting new patients
Mymichigan Medical Center Clare CurrentSince Mar 13, 2021 Accepting new patients
Mymichigan Medical Center Gladwin CurrentSince Mar 13, 2021 Accepting new patients
Mymichigan Medical Center Alma CurrentSince Mar 2, 2021 Accepting new patients
Mymichigan Medical Center Midland Past Accepting new patients
Midmichigan Urgent Care Past Accepting new patients

Locations

321 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0957

700 W 5th St
Clare, MI 48617
Phone (989) 386-9911

602 Beech St
Ste 1100
Clare, MI 48617
Phone (989) 386-9911

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

609 Quarter St
Gladwin, MI 48624
Phone (989) 246-6371

815 N Clare Ave
Harrison, MI 48625
Phone (989) 539-4096

2618 W Sugnet Rd
Midland, MI 48640
Phone (989) 633-5237

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

3009 N Saginaw Rd
#C
Midland, MI 48640
Phone (989) 633-1350

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

4611 N Campus Ridge Dr
Midland, MI 48640
Phone (844) 832-1956

Interoperability endpoints

  • Direct secure messaging: dmulder6773@mymichiganhealth.midirect.net

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 3

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1245338326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 ORCHARD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "48640",
            "telephone_number": "989-839-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 ORCHARD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "48640",
            "telephone_number": "989-839-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDER",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "DM004328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "Q22729",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.