Individual provider Active NPI

Misty Dawn McMullen, NP-C

  • Family Nurse Practitioner
  • North Versailles, PA
National Provider Identifier
1609538537
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP022936 Issued in PA
Practice address
1916 Lincoln Hwy
North Versailles, PA 15137-2706
Phone
(412) 824-5820
NPI assigned
Oct 7, 2021
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP022936 PA Primary

Addresses

Primary practice location

1916 Lincoln Hwy
North Versailles, PA 15137-2706

Mailing address

1916 Lincoln Hwy
North Versailles, PA 15137-2706
Phone (412) 824-5820

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220131001598 PA Practitioner - Nurse Practitioner 7911390752 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Medical Associates PCGroup PAC ID 9830003235, 104 clinicians

Practice addresses (Care Compare)

1916 Lincoln Hwy
North Versailles, PA 15137-2706
Phone (412) 824-5820

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.44 of 100Reported as group
Quality
78.68
Improvement activities
40
Cost
83.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Video Virtual Care, PLLC Family CurrentSince Jan 14, 2023 Accepting new patients
Premier Medical Associates PC CurrentSince Jan 6, 2025 Accepting new patients
Premier Medical Associates, PC CurrentSince Jan 6, 2025 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1218 E Lancaster Ave
Bryn Mawr, PA 19010
Phone (610) 519-1920

1181 Freedom Rd
Cranberry Twp, PA 16066
Phone (724) 742-1888

840 S Valley Forge Rd
Lansdale, PA 19446
Phone (215) 362-6303

3824 Northern Pike
Ste 200
Monroeville, PA 15146
Phone (412) 380-2800

3824 Northern Pike
Ste 300
Monroeville, PA 15146
Phone (412) 856-5335

1916 Lincoln Hwy
North Versailles, PA 15137
Phone (412) 824-5820

1500 Spruce St
Philadelphia, PA 19102
Phone (215) 790-3290

Interoperability endpoints

  • Direct secure messaging: mmcmullen994286@direct.ahn.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1609538537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 LINCOLN HWY",
            "city": "NORTH VERSAILLES",
            "state": "PA",
            "postal_code": "151372706",
            "telephone_number": "412-824-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 LINCOLN HWY",
            "city": "NORTH VERSAILLES",
            "state": "PA",
            "postal_code": "151372706",
            "telephone_number": "412-824-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "MISTY",
        "middle_name": "DAWN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP022936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Versailles, PA

Sources for this page

Verify at the official NPI Registry.