Active NPI
Ray Edward McMullen, PAC
- Medical Physician Assistant
- Lebanon, PA
National Provider Identifier
1538277975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- MA002193L
- Practice address
- 1700 S Lincoln Ave
Lebanon, PA 17042-7529 - Phone
- (717) 272-6621
- Fax
- (717) 228-6031
- NPI assigned
- Aug 27, 2006
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MA002193L | PA | Primary |
Addresses
Primary practice location
1700 S Lincoln Ave
Lebanon, PA 17042-7529
Mailing address
1593 Macintosh Way
Hummelstown, PA 17036-8730
Phone (717) 272-6621
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA002193L | Other | PA | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110406000501 | PA | Order and Referring Only - Physician Assistant | 7416131040 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1538277975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1593 MACINTOSH WAY",
"city": "HUMMELSTOWN",
"state": "PA",
"postal_code": "170368730",
"telephone_number": "717-272-6621",
"fax_number": "717-228-6031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 S LINCOLN AVE",
"city": "LEBANON",
"state": "PA",
"postal_code": "170427529",
"telephone_number": "717-272-6621",
"fax_number": "717-228-6031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMULLEN",
"first_name": "RAY",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA002193L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "MA002193L",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, PA
- Patrice A. McKenney, MD
- Tammy Sue McKissick, M.S. CCC/SLP
- Amy N McLaughlin, M.ED.
- Christine F McLaughlin, MSW
- Maryanne T. McLaughlin, M.D.
- Frances Eleanor McNamara, LPC
- Bryan James Meade, LSW
- Nina Marie Meanor
- Laura Mease, MS ED
- Medexpress Urgent Care, PC - Pennyslvania (MedExpress Urgent Care - Lebanon)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.