Individual provider Active NPI

Celene Bardales Mulholland, M.D., MPH

  • Neurological Surgery Physician
  • Pasadena, CA
National Provider Identifier
1467746453
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
R73519 Issued in AZ
Practice address
630 S Raymond Ave Unit 330
Pasadena, CA 91105-3206
Phone
(626) 793-8194
NPI assigned
Jun 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X R73519 AZ Primary

Addresses

Primary practice location

630 S Raymond Ave Unit 330
Pasadena, CA 91105-3206

Mailing address

630 S Raymond Ave Unit 330
Pasadena, CA 91105-3206
Phone (626) 793-8194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190722001805 CA Practitioner - Neurosurgery 8729314232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of California, Geffen School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern California Neurosurgical Associates IncGroup PAC ID 2466463526, 2 clinicians

Practice addresses (Care Compare)

625 Fair Oaks Ave
Suite 175
South Pasadena, CA 91030-2683
Phone (626) 793-8194

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion86
Laminectomy or laminotomy (partial removal of spine bones)30

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R73519AZMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pasadena Hospital Association, LTD. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: celenemulholland.socalna@143278.advancedmd-direct.com
  • Direct secure messaging: cmulholland419467@direct.cshs.org

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.

Hospital & facility affiliations 1

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": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1467746453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S RAYMOND AVE UNIT 330",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053206",
            "telephone_number": "626-793-8194",
            "fax_number": "626-793-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S RAYMOND AVE UNIT 330",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053206",
            "telephone_number": "626-793-8194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULHOLLAND",
        "first_name": "CELENE",
        "middle_name": "BARDALES",
        "credential": "M.D., MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-07",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AZ",
            "license": "R73519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.