Individual provider Active NPI

Jennifer Mullon, M.D.

  • Ophthalmology Physician
  • Lexington, MA
National Provider Identifier
1255482501
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
80797 Issued in MA
Practice address
21 Worthen Rd
Lexington, MA 02421-4835
Phone
(781) 862-1620
NPI assigned
Jan 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 80797 MA Primary

Addresses

Primary practice location

21 Worthen Rd
Lexington, MA 02421-4835

Mailing address

6 Stacys Way
Acton, MA 01720-3749
Phone (978) 264-0087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060403000600 MA Practitioner - Ophthalmology 9931117215 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Massachusetts Medical School, 1991
Medicare assignment
May accept Medicare assignment
Group practices
Lexington Eye Associates, IncGroup PAC ID 5698748986, 33 clinicians
Lexington Eye Associates - BidGroup PAC ID 8820315682, 33 clinicians

Practice addresses (Care Compare)

21 Worthen Rd
Lexington, MA 02421-4835
Phone (781) 862-1620

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80797MAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Eye Associates, Inc. Ophthalmology CurrentSince Jul 1, 1995 Accepting new patients
Lexington Eye Associates - Bid Ophthalmology CurrentSince Jan 14, 2015 Accepting new patients
Emerson Hospital Current Accepting new patients
Lexington Eye Associates, Inc Ophthalmology CurrentSince Jul 1, 1995 Accepting new patients
Lexington Eye Associates - Highland Healthcare Ophthalmology Past Accepting new patients
Lexington Eye Associates - Optical PastSince Dec 9, 2016 Accepting new patients

Locations

21 Worthen Rd
Lexington, MA 02421
Phone (617) 862-1620

160 Littleton Rd
Ste 9
Westford, MA 01886
Phone (781) 876-2020

Interoperability endpoints

  • Direct secure messaging: mullon.jennifer@elincdirect.org
  • Direct secure messaging: jennifer.mullon.1@24697.direct.athenahealth.com
  • Direct secure messaging: mullon.jennifer.epho@direct.partners.masshiway.net

Organizations & group practices 6

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255482501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 STACYS WAY",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017203749",
            "telephone_number": "978-264-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WORTHEN RD",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214835",
            "telephone_number": "781-862-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLON",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "80797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.