Individual provider Active NPI

Kevin Mullins

  • Student in an Organized Health Care Education/Training Program
  • Sacramento, CA
National Provider Identifier
1487077293
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4610 X St
Sacramento, CA 95817-2200
Phone
(916) 816-0536
NPI assigned
Jan 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

4610 X St
Sacramento, CA 95817-2200

Mailing address

4610 X St
Sacramento, CA 95817-2200
Phone (916) 816-0536

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
I20200806003124 CA Practitioner - Physical Medicine and RehabilitationPractitioner - Sports Medicine 5799100129 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

Merit-based Incentive Payment System (MIPS)

Final score
90.11 of 100Reported as group
Quality
86.24
Promoting interoperability
100
Improvement activities
40
Cost
78.35

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Aug 31, 2020 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 31, 2020 Accepting new patients
Regents of the University of Ca CurrentSince Aug 31, 2020 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 31, 2020 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Essent PRMC LP Past Accepting new patients

Locations

7551 Madison Ave
Citrus Hts, CA 95610
Phone (916) 904-3000

8110 Laguna Blvd
Elk Grove, CA 95758
Phone (916) 683-3955

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

1535 River Park Dr
Ste 2000
Sacramento, CA 95815
Phone (916) 286-1010

4860 Y St
Ste 1700
Sacramento, CA 95817
Phone (916) 734-2700

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

3160 Folsom Blvd
Ste 1400
Sacramento, CA 95816
Phone (916) 731-1831

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

4875 Broadway
Sacramento, CA 95820
Phone (279) 224-6000

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1487077293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 X ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172200",
            "telephone_number": "916-816-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 X ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172200",
            "telephone_number": "916-816-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-30",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.