NPIMap

Individual provider Active NPI

Rebekah Condit Mulligan, M.D.

  • Internal Medicine Physician
  • Grapevine, TX
National Provider Identifier
1598024564
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R1591 Issued in TX
Practice address
3801 William D Tate Ave Ste 840
Grapevine, TX 76051-8759
Phone
(817) 310-3772
Fax
(817) 310-3950
NPI assigned
May 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X R1591 TX
Internal Medicine Physician 207R00000X R1591 TX Primary

Addresses

Primary practice location

3801 William D Tate Ave Ste 840
Grapevine, TX 76051-8759

Mailing address

3801 William D Tate Ave Ste 840
Grapevine, TX 76051-8759
Phone (817) 310-3772

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmulligan1169418@Direct.TexasHealth.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170801001095 TX Practitioner - Internal MedicinePractitioner - Geriatric Medicine 2163662974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Texas a & M University System, HSC, College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

3801 William D Tate Ave
Suite 840
Grapevine, TX 76051-8759
Phone (817) 310-3772

Hospital & facility affiliations

  • DFW Home Health Home health agency, Fort Worth, TX, CCN 457575
  • Sunrise Home Health Services Home health agency, Bedford, TX, CCN 459463
  • Advanced Home Health Services Home health agency, Irving, TX, CCN 679671
  • Accentcare Home Health of Fort Worth Home health agency, Fort Worth, TX, CCN 747526
  • Baylor Scott & White Medical Center Grapevine Hospital, Grapevine, TX, CCN 450563
  • Texas Health Harris Methodist Hurst-Euless-Bedford Hospital, Bedford, TX, CCN 450639
  • Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044
  • Texas Health Harris Methodist Hospital Alliance Hospital, Fort Worth, TX, CCN 670085

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1591TXMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Jul 17, 2017 Accepting new patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group Internal Medicine CurrentSince Jul 17, 2017 Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

3801 William D Tate Ave
Ste 840
Grapevine, TX 76051
Phone (817) 310-3772

Interoperability endpoints

  • Direct secure messaging: rebekah.mulligan.1@18148.direct.athenahealth.com
  • Direct secure messaging: rmulligan1169418@direct.texashealth.org

Organizations & group practices 3

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 8

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": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1598024564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 WILLIAM D TATE AVE STE 840",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760518759",
            "telephone_number": "817-310-3772",
            "fax_number": "817-310-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 WILLIAM D TATE AVE STE 840",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760518759",
            "telephone_number": "817-310-3772",
            "fax_number": "817-310-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIGAN",
        "first_name": "REBEKAH",
        "middle_name": "CONDIT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-11",
        "last_updated": "2022-07-21",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "R1591",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R1591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmulligan1169418@Direct.TexasHealth.org",
            "affiliation": "N",
            "endpointDescription": "Health Information Exchange (HIE)",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3801 William D Tate Ave Ste 840",
            "city": "Grapevine",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760518759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.