Individual provider Active NPI

Kathleen B Mullin, M.D.

  • Neurology Physician
  • Stamford, CT
National Provider Identifier
1740428317
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
250448 Issued in NY
Practice address
30 Buxton Farm Rd Ste 230
Stamford, CT 06905-1206
Phone
(203) 914-1900
Fax
(203) 914-1903
NPI assigned
Feb 4, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 250448 NY Primary

Addresses

Primary practice location

30 Buxton Farm Rd Ste 230
Stamford, CT 06905-1206

Mailing address

30 Buxton Farm Rd Ste 230
Stamford, CT 06905-1206
Phone (203) 914-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Previously, effective Aug 27, 2018 through Aug 27, 2026

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai PastSince Aug 1, 2012 Accepting new patients
Cloud Health Medical Group, P.a. Past Accepting new patients
Mount Sinai School of Medicine - Dept. of Neurology Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1740428317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BUXTON FARM RD STE 230",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069051206",
            "telephone_number": "203-914-1900",
            "fax_number": "203-914-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BUXTON FARM RD STE 230",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069051206",
            "telephone_number": "203-914-1900",
            "fax_number": "203-914-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIN",
        "first_name": "KATHLEEN",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "250448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.