Individual provider Active NPI

Danielle Mulligan

  • Physician Assistant
  • Oceanside, NY
National Provider Identifier
1770389827
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1 Healthy Way
Oceanside, NY 11572-1551
Phone
(877) 768-8462
NPI assigned
Feb 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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 Primary

Addresses

Primary practice location

1 Healthy Way
Oceanside, NY 11572-1551

Mailing address

8 Morton St
Farmingdale, NY 11735-4324
Phone (631) 487-4854

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250505001827 NY Practitioner - Physician Assistant 7214454115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Nassau Physician Group PCGroup PAC ID 2264707884, 19 clinicians

Practice addresses (Care Compare)

1 Healthy Way
Oceanside, NY 11572-1551
Phone (516) 255-1581

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033516NYMDPharmacist

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 and National Provider Directory roles.

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": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1770389827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MORTON ST",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354324",
            "telephone_number": "631-487-4854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "877-768-8462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIGAN",
        "first_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.