Kenneth H Mullen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G27186 Issued in CA

Practice address

1901 W Kettleman LN
# 200
Lodi, CA 95242-4337

Phone

(209) 334-8540

Fax

(209) 368-2885

NPI assigned

Apr 27, 2006

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 CA

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: Geriatric Medicine

Education

Tulane University School of Medicine, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vienna Nursing and Rehabilitation Center Nursing home, Lodi, CA, CCN 055481

Merit-based Incentive Payment System (MIPS)

Final score

95.77 of 100Reported as apm

Quality

81.54

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Adventist Health Physicians Network

  • Multi-Specialty Clinic/Center
  • Hanford, CA
  • NPI 1063718583
  Medicare reassignment NPD
• Lodi Memorial Hospital Association, Inc

  • Primary Care Clinic/Center
  • Lodi, CA
  • NPI 1861649352
  Medicare reassignment NPD
• Adventist Health Physicians Network

  • Physical Therapy Clinic/Center
  • Paradise, CA
  • NPI 1134092190
  NPD
• Adventist Health Physicians Network

  • Endocrinology, Diabetes & Metabolism Physician
  • Lodi, CA
  • NPI 1699127316
  NPD
• Lodi Memorial Hospital Association Inc

  • Primary Care Clinic/Center
  • Lodi, CA
  • NPI 1306855523
  NPD
• Lodi Memorial Hospital Association Inc

  • General Acute Care Hospital
  • Lodi, CA
  • NPI 1316938301
  NPD
• California Em-I Medical Services, a Medical Corporation

  • Emergency Medicine Physician
  • Los Alamitos, CA
  • NPI 1477502615
  NPD (past)
• Sutter Gould Medical Foundation

  • Family Medicine Physician
  • Turlock, CA
  • NPI 1023065133
  NPD (past)
• Sutter Gould Medical Foundation

  • Family Medicine Physician
  • Modesto, CA
  • NPI 1326093360
  NPD (past)

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

• Vienna Convalescent Hospital, Inc.

  • Skilled Nursing Facility
  • Lodi, CA
  • NPI 1972501823

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1922065721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241011",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952419511",
            "telephone_number": "209-339-7435",
            "fax_number": "209-339-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W KETTLEMAN LN",
            "address_2": "# 200",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424337",
            "telephone_number": "209-334-8540",
            "fax_number": "209-368-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "KENNETH",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G27186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• George W Mowry, MD
• Kevin M Moynihan, MD
• Jessica R Mueller, RD
• Sheila Layah Mulvihill, M.A.
• Misty Dawn Munoz
• Demonte Louis Murray
• Elyse Alexandra Muscha
• Elizabeth Myhre

• Family Medicine Physician in Lodi, CA
• Providers in Lodi, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; 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.