Individual provider Active NPI

Elizabeth Stone Mulley, PA-C

  • Physician Assistant
  • Concord, MA
National Provider Identifier
1700611225
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
131 Old Road to Nine Acre Corner
Medical Office Building, Suite 230
Concord, MA 01742
Phone
(978) 287-8950
NPI assigned
Sep 4, 2024
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

131 Old Road to Nine Acre Corner
Medical Office Building, Suite 230
Concord, MA 01742

Mailing address

131 Old Road to Nine Acre Corner
Medical Office Building, Suite 230
Concord, MA 01742
Phone (978) 287-8950

Other practice location 1

179 Longwood Ave
Boston, MA 02115-5804
Phone (617) 732-2918

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20241212002738 MA Practitioner - Physician Assistant 4082140173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emerson Practice Associates, IncGroup PAC ID 8123188117, 247 clinicians

Practice addresses (Care Compare)

133 Old Rd to 9 Acre Cor
Concord, MA 01742-4159
Phone (978) 287-3020

133 Old Rd to Nine Acre Corner
Mary Beth Misserville
Concord, MA 01742-4159

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: mulley.elizabeth.epa@direct.partners.masshiway.net

Organizations & group practices 1

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": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1700611225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 OLD ROAD TO NINE ACRE CORNER",
            "address_2": "MEDICAL OFFICE BUILDING, SUITE 230",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "01742",
            "telephone_number": "978-287-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 OLD ROAD TO NINE ACRE CORNER",
            "address_2": "MEDICAL OFFICE BUILDING, SUITE 230",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "01742",
            "telephone_number": "978-287-8950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "179 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155804",
            "country_code": "US",
            "telephone_number": "617-732-2918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLEY",
        "first_name": "ELIZABETH",
        "middle_name": "STONE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-04",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.