Individual provider Active NPI

Matthew Ryan Mulloy, MD

  • Transplant Surgery Physician
  • Dallas, TX
National Provider Identifier
1639375892
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transplant Surgery PhysicianTaxonomy code 204F00000X
License
N3197 Issued in TX
Practice address
7777 Forest LN Ste B445
Dallas, TX 75230-6877
Phone
(972) 566-6900
Fax
(972) 566-6993
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X N3197 TX Primary

Addresses

Primary practice location

7777 Forest LN Ste B445
Dallas, TX 75230-6877

Mailing address

7777 Forest LN Ste B445
Dallas, TX 75230-6877
Phone (972) 566-6900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090728000193 TX Practitioner - General SurgeryPractitioner - Other (Physician) 4082767843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Indiana University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical City Transplant, PLLCGroup PAC ID 6709176654, 18 clinicians

Practice addresses (Care Compare)

900 8TH Ave
Fort Worth, TX 76104-3902
Phone (817) 555-1212

Hospital & facility affiliations

  • Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647
  • Medical City Fort Worth Hospital, Fort Worth, TX, CCN 450672

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37404TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Pediatric Neurosurgery Specialists, PLLC PastSince Oct 8, 2016 Accepting new patients
Columbia Hospital at Medical City Dallas Subsidiary LP Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: matthew.mulloy@hca2.eclinicaldirectplus.com

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 3

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1639375892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE B445",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306877",
            "telephone_number": "972-566-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE B445",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306877",
            "telephone_number": "972-566-6900",
            "fax_number": "972-566-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLOY",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "TX",
            "license": "N3197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.