Individual provider Active NPI

Thomas Campbell Mulhern, PA-C

  • Medical Physician Assistant
  • Golden, CO
National Provider Identifier
1265065718
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.0008015 Issued in CO
Practice address
730 Simms St Unit 536
Golden, CO 80401-5127
Phone
(708) 466-9741
NPI assigned
Feb 12, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA59963 CA
Medical Physician Assistant 363AM0700X PA.0008015 CO Primary

Addresses

Primary practice location

730 Simms St Unit 536
Golden, CO 80401-5127

Mailing address

730 Simms St Unit 536
Golden, CO 80401-5127
Phone (708) 466-9741

Other practice location 1

10710 N Torrey Pines Rd
LA Jolla, CA 92037-1035
Phone (619) 849-4469

Other practice location 2

240 E. Huron St.
McGaw Pavilion, Suite 1-200
Chicago, IL 60611-6061
Phone (312) 503-1851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA59963CAMDPhysician Assistant
PA.0008015COMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1265065718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 SIMMS ST UNIT 536",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804015127",
            "telephone_number": "708-466-9741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 SIMMS ST UNIT 536",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804015127",
            "telephone_number": "708-466-9741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10710 N Torrey Pines Rd",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "920371035",
            "country_code": "US",
            "telephone_number": "619-849-4469",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "240 E. Huron St.",
            "address_2": "McGaw Pavilion, Suite 1-200",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606116061",
            "country_code": "US",
            "telephone_number": "312-503-1851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULHERN",
        "first_name": "THOMAS",
        "middle_name": "CAMPBELL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-12",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA59963",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0008015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.