Individual provider Active NPI

Brian Melvin Mullins, MS., PT

  • Physical Therapist
  • Neptune, NJ
National Provider Identifier
1366529497
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
QA0859400 Issued in NJ
Practice address
788 Wayside Rd
Neptune, NJ 07753-2735
Phone
(732) 922-6618
Fax
(732) 922-6619
NPI assigned
Nov 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X QA0859400 NJ Primary

Addresses

Primary practice location

788 Wayside Rd
Neptune, NJ 07753-2735

Mailing address

788 Wayside Rd
Neptune, NJ 07753-2735
Phone (732) 922-6618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110324000074 NJ Practitioner - Physical Therapist in Private Practice 2466635768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Monmouth Physical Therapy LLCGroup PAC ID 1850338252, 3 clinicians

Practice addresses (Care Compare)

301 Bingham Ave
Suite a
Ocean, NJ 07712-4764
Phone (732) 922-6618

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
QA0859400NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Monmouth Physical Therapy LLC Physical Therapist CurrentSince Jan 8, 2003 Accepting new patients

Locations

788 Wayside Rd
Neptune, NJ 07753
Phone (732) 922-6618

301 Bingham Ave
Ste A
Ocean, NJ 07712
Phone (732) 775-9077

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366529497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 WAYSIDE RD",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077532735",
            "telephone_number": "732-922-6618",
            "fax_number": "732-922-6619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 WAYSIDE RD",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077532735",
            "telephone_number": "732-922-6618",
            "fax_number": "732-922-6619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "BRIAN",
        "middle_name": "MELVIN",
        "name_prefix": "Mr.",
        "credential": "MS., PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QA0859400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.