Individual provider Active NPI

Ryan Mullen, PA

  • Physician Assistant
  • Worcester, MA
National Provider Identifier
1326304197
Registry record updated Apr 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
123 Summer St
Worcester, MA 01608-1216
Phone
(866) 691-6774
NPI assigned
Apr 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

123 Summer St
Worcester, MA 01608-1216

Mailing address

PO Box 414977
Boston, MA 02241-4977
Phone (866) 691-6774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120823000777 MA Practitioner - Physician Assistant 2163679226 Reassigns benefits to 5 organizations
I20260129000983 NH Practitioner - Physician Assistant 2163679226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Hampshire Emergency Physician Associates PCGroup PAC ID 2668735580, 25 clinicians

Practice addresses (Care Compare)

10 Hospital Dr
Holyoke, MA 01040-6603

240 S Main St
Wolfeboro, NH 03894-4411
Phone (856) 686-4316

575 Beech St
Holyoke, MA 01040-2223
Phone (413) 534-2697

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3579NHMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Jul 1, 2012 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 1, 2019 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Jul 1, 2012 Accepting new patients
Massachusetts General Physicians Organization, Inc CurrentSince Mar 22, 2016 Accepting new patients
Western Mass Physician Associates Inc CurrentSince Apr 1, 2025 Accepting new patients
New Hampshire Emergency Physician Associates PC CurrentSince Mar 1, 2026 Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

10 Hospital Dr
Ste 306
Holyoke, MA 01040
Phone (413) 539-6830

15 Hospital Dr
Ste 50
Holyoke, MA 01040
Phone (413) 534-2826

575 Beech St
Holyoke, MA 01040
Phone (413) 534-2570

199 Reedsdale Rd
Milton, MA 02186
Phone (617) 313-1000

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

100 South St
Southbridge, MA 01550
Phone (508) 764-8012

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

452 Old Street Rd
Peterborough, NH 03458
Phone (603) 924-4699

240 S Main St
Wolfeboro, NH 03894
Phone (603) 515-2093

Interoperability endpoints

  • Direct secure messaging: rmullen@landmarkhealth-direct.org
  • Direct secure messaging: rmullen3336543@direct.trinity-health.org

Organizations & group practices 7

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 3

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": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333670400000",
    "number": "1326304197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 414977",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022414977",
            "telephone_number": "866-691-6774",
            "fax_number": "781-276-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "866-691-6774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "RYAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-06",
        "last_updated": "2012-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.