Elizabeth Catherine Mullen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0160341 Issued in NY

Practice address

4 Coulter Rd Ste 1630
Clifton Springs, NY 14432-1122

Phone

(315) 462-1495

NPI assigned

Sep 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Elizabeth Catherine Willistein Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1063531929
  NPD (past)
• Dermatology Assoc of Erie

  • Dermatology Physician
  • Erie, PA
  • NPI 1821099623
  NPD (past)

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1609126325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HIGHWAY SOUTH",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14617",
            "telephone_number": "585-922-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 COULTER RD STE 1630",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144321122",
            "telephone_number": "315-462-1495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3416 State St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165082832",
            "country_code": "US",
            "telephone_number": "814-456-7548",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3416 State St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165082832",
            "country_code": "US",
            "telephone_number": "814-456-7548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "ELIZABETH",
        "middle_name": "CATHERINE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0160341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "WILLISTEIN",
            "middle_name": "CATHERINE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nancy M Miller
• Mohammed S Rehmani Internal Medicine PC
• Les Moore, N.D.,LAC
• Karin Morton, M.A. CCC-SLP
• Cecilia Mae Mulkin, LCSW
• Hannah Murphy, OTR/L
• Sabrina Murphy
• Arun K Nagpaul, MD
• Chester Nakamura, MD
• William M Neilsen, DDS

• Physician Assistant in Clifton Springs, NY
• Providers in Clifton Springs, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.