Individual provider Active NPI

Justin M Mullaney, DNP

  • Certified Registered Nurse Anesthetist
  • Sebastian, FL
National Provider Identifier
1295223022
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11007281 Issued in FL
Practice address
13695 US Highway 1
Sebastian, FL 32958-3230
Phone
(716) 603-8140
NPI assigned
Apr 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 667991 NY
Certified Registered Nurse Anesthetist 367500000X APRN11007281 FL Primary

Addresses

Primary practice location

13695 US Highway 1
Sebastian, FL 32958-3230

Mailing address

13695 US Highway 1
Sebastian, FL 32958-3230
Phone (716) 603-8140

Other practice location 1

2157 Main St
Buffalo, NY 14214-2648
Phone (716) 836-7510 ext. 106

Other identifiers 1

IdentifierTypeStateIssuer
119959900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180719002247 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557618709 Reassigns benefits to 1 organization
I20200910002282 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557618709 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

13695 US Hwy 1
Sebastian, FL 32958-3230
Phone (722) 589-3186

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
APRN11007281FLMDCertified Registered Nurse Anesthetist
667991NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Live Oak Endoscopy Center, LLC CurrentSince Oct 16, 2024 Accepting new patients
Steward Anesthesiology Physicians of Florida Inc. CurrentSince Sep 14, 2020 Accepting new patients
Parkside Medical Anesthesia Associates Nurse Anesthetist, Certified Registered CurrentSince Jul 2, 2018 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 1, 2025 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 1, 2025 Accepting new patients
Vero Anesthesia CurrentSince Apr 6, 2025 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

275 18th St
Ste 101
Vero Beach, FL 32960
Phone (772) 299-5005

3871 Harlem Rd
Ste 202
Buffalo, NY 14215

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

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": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1295223022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13695 US HIGHWAY 1",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583230",
            "telephone_number": "716-603-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13695 US HIGHWAY 1",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583230",
            "telephone_number": "716-603-8140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2157 Main St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142142648",
            "country_code": "US",
            "telephone_number": "716-836-7510 x106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLANEY",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-26",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "667991",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11007281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119959900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.