Individual provider Active NPI

Megan Kathleen Mullin, CRNP-BC

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1265862510
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP013288 Issued in PA
Practice address
111 S 11TH St Ste 8490
Philadelphia, PA 19107-4824
Phone
(215) 955-1120
Fax
(215) 955-2420
NPI assigned
Nov 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP013288 PA Primary

Addresses

Primary practice location

111 S 11TH St Ste 8490
Philadelphia, PA 19107-4824

Mailing address

1025 Walnut St
Philadelphia, PA 19107-5001
Phone (267) 243-3195

Other practice location 1

900 Walnut St
Philadelphia, PA 19107-5191
Phone (215) 955-6161

Other practice location 2

1025 Walnut St
Philadelphia, PA 19107-5001
Phone (267) 243-3195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20171220000460 PA Practitioner - Nurse Practitioner 3375774862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

111 S 11TH St
Suite 8490
Philadelphia, PA 19107-4824
Phone (215) 955-6161

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Nov 1, 2017 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

900 Walnut St
Fl 2
Philadelphia, PA 19107
Phone (215) 955-1234

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

111 S 11th St
Ste 8490
Philadelphia, PA 19107
Phone (215) 955-6161

1100 Walnut St
Ste 500
Philadelphia, PA 19107
Phone (215) 955-6750

900 Walnut St
Philadelphia, PA 19107
Phone (215) 503-8080

Organizations & group practices 2

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": "1385164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1265862510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 WALNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075001",
            "telephone_number": "267-243-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST STE 8490",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-1120",
            "fax_number": "215-955-2420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075191",
            "country_code": "US",
            "telephone_number": "215-955-6161",
            "fax_number": "215-923-5507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191075001",
            "country_code": "US",
            "telephone_number": "267-243-3195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLIN",
        "first_name": "MEGAN",
        "middle_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "CRNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-23",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP013288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.