Sean Mullendore, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

21562 Issued in NE

Practice address

3308 Samson Way
Suite 101
Bellevue, NE 68123-3194

Phone

(402) 827-1577

Fax

(402) 898-3134

NPI assigned

Aug 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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.

Enrollment records 1

Specialty

Family PracticeAlso: Sports Medicine

Education

Wayne State University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI Health at Home - Omaha Home health agency, Omaha, NE, CCN 287019
• CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
• CHI Health Midlands Hospital, Papillion, NE, CCN 280105
• CHI Health Lakeside Hospital, Omaha, NE, CCN 280130

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smullendore8594@achce.catholichealth.net

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.

• Alegent Creighton Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907

  Sports Medicine

  Medicare reassignment Care Compare group NPD
• Alegent Creighton Clinic

  • Internal Medicine Physician
  • Omaha, NE
  • NPI 1154680700
  NPD
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069

  Sports Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alegent Creighton Health

  • General Acute Care Hospital
  • Papillion, NE
  • NPI 1215006101
  Care Compare affiliation
• Alegent Creighton Health

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1649355132
  Care Compare affiliation
• Alegent Health Bergan Mercy Health System

  • Psychiatric Hospital Unit
  • Omaha, NE
  • NPI 1396969499
  Care Compare affiliation
• Alegent Health Bergan Mercy Health System

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1508941097
  Care Compare affiliation
• CHI National Home Care, LLC

  • Home Health Agency
  • Omaha, NE
  • NPI 1932532876
  Care Compare affiliation

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220486400000",
    "number": "1821081365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 642117",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681648117",
            "telephone_number": "402-717-4377",
            "fax_number": "402-717-4317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308 SAMSON WAY",
            "address_2": "SUITE 101",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681233194",
            "telephone_number": "402-827-1577",
            "fax_number": "402-898-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLENDORE",
        "first_name": "SEAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2008-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NE",
            "license": "21562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trenell Ray Moss
• Brianna Mostek
• Margaret Noll Motts, PT
• Marissa Moya
• Ferezzia Mpanzu
• Allenia A'Nyce Mullins
• Roberta Mulroy
• Malynda Carlene Mulvany, M.ED., CCC-SLP
• Marquetta Mumphrey
• Codi Nicole Mundell

• Sports Medicine (Family Medicine) Physician in Bellevue, NE
• Providers in Bellevue, NE by specialty
• Sports Medicine (Family Medicine) Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.

Verify at the official NPI Registry.