Individual provider Active NPI

Steven M Mullen, PT

  • Physical Therapist
  • Lafayette, CO
National Provider Identifier
1508996356
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7855 Issued in CO
Practice address
280 Exempla Cir
Lafayette, CO 80026-3370
Phone
(303) 338-4545
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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 7855 CO Primary

Addresses

Primary practice location

280 Exempla Cir
Lafayette, CO 80026-3370

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other identifiers 2

IdentifierTypeStateIssuer
35232510MedicaidCO
017652OtherKAISER-COMMERCIAL NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090902000417 CO Practitioner - Physical Therapist in Private Practice 2567517204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Permanente Medical Group PCGroup PAC ID 1254238454, 1,325 clinicians

Practice addresses (Care Compare)

280 Exempla Circle
Kaiser Permanente Rock Creek Medica
Lafayette, CO 80026-3370
Phone (303) 338-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7855COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Permanente Medical Group, P.C. CurrentSince Jan 8, 2020 Accepting new patients

Locations

10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350

14701 E Exposition Ave
Denver, CO 80012
Phone (303) 614-7373

280 Exempla Cir
Lafayette, CO 80026

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1508996356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 EXEMPLA CIR",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263370",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "STEVEN",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "7855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35232510",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER-COMMERCIAL NUMBER",
            "identifier": "017652",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "CAREQUALITY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "280 Exempla Cir",
            "city": "Lafayette",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800263370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.