Individual provider Active NPI

Daniel A Mulrooney, MD

  • Pediatric Hematology & Oncology Physician
  • Memphis, TN
National Provider Identifier
1316023328
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
48440 Issued in TN
Practice address
262 Danny Thomas PL
Memphis, TN 38105-3678
Phone
(888) 226-4343
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 48440 TN Primary

Addresses

Primary practice location

262 Danny Thomas PL
Memphis, TN 38105-3678

Mailing address

262 Danny Thomas PL # Ms 515
Memphis, TN 38105-3678

Other identifiers 11

IdentifierTypeStateIssuer
36-00567OtherMEDICA CHOICE
0583294MedicaidIA
929S7MUOtherBLUE CROSS BLUE SHIELD
34573100MedicaidWI
0080461MedicaidMT
2267970OtherARAZ
757623400MedicaidMN
HP47960OtherHEALTH PARTNERS
1042474OtherPREFERRED ONE
132408OtherUCARE
36-12094OtherMEDICA PRIMARY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sjcrhenrollment@stjude.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220608001350 TN Practitioner - Pediatric Medicine 3779544820 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48440TNMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Jude Children'S Research Hospital, Inc. Pediatric Hematology-Oncology CurrentSince Mar 3, 2022 Accepting new patients
St Jude Childrens Research Hospital Inc Past Accepting new patients

Locations

262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343

262 Danny Thomas Pl
#515
Memphis, TN 38105
Phone (901) 495-3006

Interoperability endpoints

  • Direct secure messaging: dmulrooney21500@stjude.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1316023328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 DANNY THOMAS PL # MS 515",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381053678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 DANNY THOMAS PL",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381053678",
            "telephone_number": "888-226-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULROONEY",
        "first_name": "DANIEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "TN",
            "license": "48440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "36-00567",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0583294",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "929S7MU",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34573100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080461",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ",
            "identifier": "2267970",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "757623400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP47960",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1042474",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "132408",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PRIMARY",
            "identifier": "36-12094",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjcrhenrollment@stjude.org",
            "affiliation": "N",
            "address_1": "262 Danny Thomas Pl",
            "city": "Memphis",
            "state": "TN",
            "country_code": "US",
            "postal_code": "381053678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.