Active NPI
Mathew J Pulicken, MD
- Neurology Physician
- Reno, NV
National Provider Identifier
1629231832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 984370
- Practice address
- 75 Pringle Way Ste 401
Reno, NV 89502-1476 - Phone
- (775) 982-5000
- Fax
- (775) 982-2973
- NPI assigned
- Jul 8, 2008
- Last updated
- Jan 3, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | MD13907 | RI | |
| Neurology Physician | 2084N0400X | 984370 | NV | Primary |
Addresses
Primary practice location
75 Pringle Way Ste 401
Reno, NV 89502-1476
Mailing address
1155 Mill St # M14
Reno, NV 89502-1576
Phone (775) 982-5262
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23127 | Other | NV | NEVADA LIC |
| 1102512 | Other | NV | CAQH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
27 Park St
Hyannis, MA 02601-5230
Phone (774) 552-6000
46 N St
Suite 7
Hyannis, MA 02601-3845
Phone (508) 833-2639
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.15 of 100
- Quality
- 79.09
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.43
Merit-based Incentive Payment System (MIPS)
- Final score
- 76.23 of 100
- Quality
- 56.78
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.3 of 100
- Quality
- 71.45
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 984370 | NV | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Affiliates of Cape Cod, Inc. | Current | Accepting new patients | |
| Physicians of Cape Cod Hospital | Current | Accepting new patients | |
| Medical Affiliates of Cape Cod, Inc. | Neurology | Current | Accepting new patients |
| Memorial Hospital | Past | Accepting new patients |
Locations
27 Park St
Hyannis, MA 02601
Phone (508) 775-5011
46 North St
Ste 7
Hyannis, MA 02601
Phone (508) 775-2295
Interoperability endpoints
- mpulicken193939@direct.renown.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.
-
- Internal Medicine Physician
- Hyannis, MA
- NPI 1770534927
Neurology
-
- Neuroradiology Physician
- Hyannis, MA
- NPI 1679832364
-
- Ambulatory Surgical Clinic/Center
- Mashpee, MA
- NPI 1306391206
-
- General Acute Care Hospital
- Pawtucket, RI
- NPI 1548696941
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": "1215475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672704000000",
"number": "1629231832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1155 MILL ST # M14",
"city": "RENO",
"state": "NV",
"postal_code": "895021576",
"telephone_number": "775-982-5262",
"fax_number": "775-982-5496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 PRINGLE WAY STE 401",
"city": "RENO",
"state": "NV",
"postal_code": "895021476",
"telephone_number": "775-982-5000",
"fax_number": "775-982-2973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PULICKEN",
"first_name": "MATHEW",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-08",
"last_updated": "2023-01-03",
"certification_date": "2023-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "RI",
"license": "MD13907",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NV",
"license": "984370",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEVADA LIC",
"identifier": "23127",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "1102512",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.
- 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.