Active NPI
Elise Carolyn Mullen, PA-C
- Physician Assistant
- Danville, PA
National Provider Identifier
1700658010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA065137
- Practice address
- 100 N Academy Ave
Danville, PA 17822-0001 - Phone
- (570) 271-6211
- NPI assigned
- Oct 30, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MA065137 | PA | |
| Physician Assistant | 363A00000X | MA065137 | PA | Primary |
Addresses
Primary practice location
100 N Academy Ave
Danville, PA 17822-0001
Mailing address
100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231201002455 | PA | Practitioner - Physician Assistant | 0244688166 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144
Hospital & facility affiliations
- Geisinger Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA065137 | PA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Geisinger-HM Joint Venture, LLC | Current | Accepting new patients | |
| Geisinger-HM Joint Venture, LLC | Physician Assistant | Current | Accepting new patients |
| Geisinger Clinic | Current | Accepting new patients | |
| Geisinger Clinic | Current | Accepting new patients | |
| Geisinger Clinic | Past | Accepting new patients |
Locations
4200 Hospital Rd
Coal Township, PA 17866
Phone (570) 644-4200
100 N Academy Ave
Danville, PA 17822
400 Highland Ave
Lewistown, PA 17044
Phone (717) 242-7473
10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566
255 Route 220 Hwy
Muncy, PA 17756
Phone (570) 308-2600
Organizations & group practices 7
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.
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Hospital & facility affiliations 26
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": "1698624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703116800000",
"number": "1700658010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178224903",
"telephone_number": "570-271-6144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178220001",
"telephone_number": "570-271-6211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLEN",
"first_name": "ELISE",
"middle_name": "CAROLYN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-30",
"last_updated": "2023-12-21",
"certification_date": "2023-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA065137",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA065137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.