Individual provider Active NPI

Daniel Kast Mullady, MD

  • Gastroenterology Physician
  • Savannah, GA
National Provider Identifier
1447371034
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
91385 Issued in GA
Practice address
1139 Lexington Ave Ste a
Savannah, GA 31404-5502
Phone
(912) 303-4200
Fax
(912) 790-2701
NPI assigned
Apr 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 91385 GA Primary

Addresses

Primary practice location

1139 Lexington Ave Ste a
Savannah, GA 31404-5502

Mailing address

1139 Lexington Ave Ste a
Savannah, GA 31404-5502
Phone (912) 303-4200

Other practice location 1

11705 Mercy Blvd
Savannah, GA 31419-1791
Phone (912) 819-4100

Other practice location 2

1000 Towne Center Blvd Ste 701
Pooler, GA 31322-4063
Phone (912) 303-4200

Other practice location 3

5353 Reynolds St
Savannah, GA 31405-6015
Phone (912) 819-6000

Other practice location 4

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-8000

Other identifiers 1

IdentifierTypeStateIssuer
206378200MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20220422001088 GA Practitioner - Gastroenterology 6305914573 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Connecticut School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aga, LLCGroup PAC ID 2365431350, 138 clinicians
Aga Professional Services LLCGroup PAC ID 3870768997, 175 clinicians

Practice addresses (Care Compare)

1139 Lexington Ave
Suite a
Savannah, GA 31404-5502
Phone (913) 203-4200

2520 Windy Hill Rd SE
Suite 102
Marietta, GA 30067-8633
Phone (770) 612-8165

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy65
Upper gastrointestinal (GI) endoscopy for acid reflux376

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aga Professional Services, LLC Gastroenterology CurrentSince Apr 1, 2022 Accepting new patients
Aga, LLC Gastroenterology CurrentSince Apr 1, 2022 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

2520 Windy Hill Rd SE
Ste 102
Marietta, GA 30067
Phone (770) 612-8165

488 Kennesaw Ave NW
Ste 200
Marietta, GA 30060
Phone (770) 427-3075

1000 Towne Center Blvd
Ste 701
Pooler, GA 31322
Phone (912) 303-4200

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

1139 Lexington Ave
Ste A
Savannah, GA 31404
Phone (912) 303-4200

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d88010de-d791-42d4-b72d-513f9afc5ed1/
  • Direct secure messaging: daniel.mullady@ud.eclinicaldirectplus.com

Organizations & group practices 4

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1447371034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 LEXINGTON AVE STE A",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314045502",
            "telephone_number": "912-303-4200",
            "fax_number": "912-790-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 LEXINGTON AVE STE A",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314045502",
            "telephone_number": "912-303-4200",
            "fax_number": "912-790-2701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11705 Mercy Blvd",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314191791",
            "country_code": "US",
            "telephone_number": "912-819-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Towne Center Blvd Ste 701",
            "address_purpose": "LOCATION",
            "city": "Pooler",
            "state": "GA",
            "postal_code": "313224063",
            "country_code": "US",
            "telephone_number": "912-303-4200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5353 Reynolds St",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314056015",
            "country_code": "US",
            "telephone_number": "912-819-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4700 Waters Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-350-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLADY",
        "first_name": "DANIEL",
        "middle_name": "KAST",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "91385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206378200",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.