Active NPI
John Mullin, P.A.
- Physician Assistant
- Staten Island, NY
National Provider Identifier
1457527095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 010986-1
- Practice address
- 1414 Victory Blvd
Staten Island, NY 10301-3908 - Phone
- (718) 447-1261
- NPI assigned
- May 4, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 010986-1 | NY | Primary |
Addresses
Primary practice location
1414 Victory Blvd
Staten Island, NY 10301-3908
Mailing address
1414 Victory Blvd
Staten Island, NY 10301-3908
Phone (718) 447-1261
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2873 W 17TH St
Brooklyn, NY 11224-2611
Phone (718) 265-9900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010986-1 | NY | MD | Speech-Language Pathologist |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
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.
-
- Clinic/Center
- Brooklyn, NY
- NPI 1063278281
-
- Adolescent Medicine (Family Medicine) Physician
- Brooklyn, NY
- NPI 1972848307
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493856000000",
"number": "1457527095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 VICTORY BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103013908",
"telephone_number": "718-447-1261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 VICTORY BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103013908",
"telephone_number": "718-447-1261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLIN",
"first_name": "JOHN",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-04",
"last_updated": "2017-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "010986-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.