Individual provider Active NPI

Joseph Daniel Mullen, MD

  • Diagnostic Radiology Physician
  • Lakeland, FL
National Provider Identifier
1871721167
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME122542 Issued in FL
Practice address
2125 Crystal Grove Dr
Lakeland, FL 33801-6875
Phone
(863) 688-2334
NPI assigned
Jun 25, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME122542 FL Primary

Addresses

Primary practice location

2125 Crystal Grove Dr
Lakeland, FL 33801-6875

Mailing address

2125 Crystal Grove Dr
Lakeland, FL 33801-6875
Phone (863) 688-2334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20150608002225 FL Practitioner - Diagnostic Radiology 7911127592 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Saint Louis University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Scanning Consultants PAGroup PAC ID 9032005376, 82 clinicians

Practice addresses (Care Compare)

1640 N Maitland Ave
Suite 1020
Maitland, FL 32751-3320
Phone (407) 363-2772

809 County Rd
466 Suite 400
Lady Lake, FL 32159-4205
Phone (352) 753-2660

9350 Turkey Lake Rd
Suite 100
Orlando, FL 32819-7316
Phone (407) 363-2772

964 S Orlando Ave
Winter Park, FL 32789-4849
Phone (407) 628-5051

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME122542FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Centers of America LLP Diagnostic Radiology CurrentSince Aug 14, 2023 Accepting new patients
Women's Care Florida LLC CurrentSince Feb 1, 2016 Accepting new patients
Manatee Memorial Hospital LP CurrentSince Feb 19, 2018 Accepting new patients
Medical Scanning Consultants PA Diagnostic Radiology CurrentSince Mar 29, 2022 Accepting new patients
Medical Scanning Consultants PA Diagnostic Radiology CurrentSince Mar 29, 2022 Accepting new patients
Manatee Memorial Hospital L P Current Accepting new patients
Diagnostic Centers of America LLP Diagnostic Radiology CurrentSince Aug 14, 2023 Accepting new patients
Manatee Memorial Hospital L P CurrentSince Feb 19, 2018 Accepting new patients

Locations

206 2nd St E
Bradenton, FL 34208
Phone (941) 745-7202

1640 N Maitland Ave
#1020
Maitland, FL 32751
Phone (407) 363-2772

1781 Park Center Dr
Ste 110
Orlando, FL 32835
Phone (407) 253-7190

9350 Turkey Lake Rd
Ste 100
Orlando, FL 32819
Phone (407) 363-2772

1000 W Broadway St
Ste 140
Oviedo, FL 32765
Phone (407) 359-6001

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

2102 Trinity Oaks Blvd
#171
Trinity, FL 34655
Phone (727) 376-7734

1572 Palm Beach Lakes Blvd
Ste 2
West Palm Beach, FL 33401

964 S Orlando Ave
Winter Park, FL 32789
Phone (407) 628-5051

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 9

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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1871721167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 CRYSTAL GROVE DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338016875",
            "telephone_number": "863-688-2334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 CRYSTAL GROVE DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338016875",
            "telephone_number": "863-688-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "JOSEPH",
        "middle_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-25",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME122542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.