Active NPI
John Thomas Mullen, PHD
- Psychologist
- Minneapolis, MN
National Provider Identifier
1700850823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP4239
- Practice address
- 913 E 26TH St Ste 503
Minneapolis, MN 55404-4515 - Phone
- (612) 863-5100
- Fax
- (612) 863-5109
- NPI assigned
- Feb 15, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP4239 | MN | |
| Psychologist | 103T00000X | LP4239 | MN | Primary |
Addresses
Primary practice location
913 E 26TH St Ste 503
Minneapolis, MN 55404-4515
Mailing address
913 E 26TH St Ste 503
Minneapolis, MN 55404-4515
Phone (612) 863-5100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 604909500 | Medicaid | MN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jmullen324119@excellian.direct.allina.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051130000170 | MN | Practitioner - Clinical Psychologist | 2668492018 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Allina Health System
Practice addresses (Care Compare)
800 E 28TH St
Suite H2100
Minneapolis, MN 55407-3723
Phone (612) 863-3900
Hospital & facility affiliations
- Abbott Northwestern Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.6 of 100
- Quality
- 72.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.07
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients |
Locations
2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640
800 E 28th St
Ste H2100
Minneapolis, MN 55407
Phone (612) 863-3900
2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800
913 E 26th St
Ste 503
Minneapolis, MN 55404
Phone (612) 863-0310
Interoperability endpoints
- jmullen324119@excellian.direct.allina.com
Organizations & group practices 2
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.
-
- Rheumatology Physician
- Coon Rapids, MN
- NPI 1952146516
Hospital & facility affiliations 23
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Obesity Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1154684835
Hospital
-
- Physical Medicine & Rehabilitation Physician
- Minneapolis, MN
- NPI 1275577215
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604966400000",
"number": "1700850823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "913 E 26TH ST STE 503",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554044515",
"telephone_number": "612-863-5100",
"fax_number": "612-863-5109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "913 E 26TH ST STE 503",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554044515",
"telephone_number": "612-863-5100",
"fax_number": "612-863-5109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLEN",
"first_name": "JOHN",
"middle_name": "THOMAS",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-15",
"last_updated": "2020-11-10",
"certification_date": "2020-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP4239",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP4239",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "604909500",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jmullen324119@excellian.direct.allina.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/PDF/TXT",
"address_1": "913 E 26th St Ste 503",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554044515",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.