NPIMap

Organization Active NPI

John Mulawka DO, PC

  • Pediatrics Physician
  • Derby, NY
National Provider Identifier
1831440932
Registry record updated Sep 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
224453 Issued in NY
Legal business name
JOHN MULAWKA DO, PC
Practice address
6763 Erie Rd
Derby, NY 14047-9670
Phone
(716) 947-2222
Fax
(716) 947-2223
NPI assigned
Sep 28, 2012
Last updated
Sep 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2012

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

Authorized official

Name
John Michael Mulawka III, DONPI 1417037755
Title
Owner
Phone
(716) 947-2222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 224453 NY Primary

Addresses

Primary practice location

6763 Erie Rd
Derby, NY 14047-9670

Mailing address

6763 Erie Rd
Derby, NY 14047-9670
Phone (716) 947-2222

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1049131John Mulawka DO PC6763 Erie Road, Derby, NY 14047Certificate of waiverDec 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
John Mulawka DO PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6763 Erie Rd
Derby, NY 14047
Phone (716) 947-2222

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348790400000",
    "number": "1831440932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6763 ERIE RD",
            "city": "DERBY",
            "state": "NY",
            "postal_code": "140479670",
            "telephone_number": "716-947-2222",
            "fax_number": "716-947-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6763 ERIE RD",
            "city": "DERBY",
            "state": "NY",
            "postal_code": "140479670",
            "telephone_number": "716-947-2222",
            "fax_number": "716-947-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN MULAWKA DO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-28",
        "last_updated": "2012-09-28",
        "status": "A",
        "authorized_official_last_name": "MULAWKA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-947-2222",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "224453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.