NPIMap

Individual provider Active NPI

Kevin Mullins, MD

  • Neurological Surgery Physician
  • West Islip, NY
National Provider Identifier
1982674461
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
1903771 Issued in NY
Practice address
1175 Montauk Hwy
Ste 6
West Islip, NY 11795-4939
Phone
(833) 666-6066
Fax
(631) 337-7698
NPI assigned
Jan 25, 2006
Last updated
Sep 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 1903771 NY Primary

Addresses

Primary practice location

1175 Montauk Hwy
Ste 6
West Islip, NY 11795-4939

Mailing address

1175 Montauk Hwy Ste 6
West Islip, NY 11795-4939
Phone (833) 666-6066

Other identifiers 2

IdentifierTypeStateIssuer
01924574MedicaidNY
P00077933OtherNYMEDICARE RR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040609000780 NY Practitioner - Neurosurgery 6204818065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Rochester School of Medicine and Dentistry, 1991
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
True North Medical of Suffolk PCGroup PAC ID 6204372758, 2 clinicians

Practice addresses (Care Compare)

1175 Montauk Hwy
Suite 6
West Islip, NY 11795-4939
Phone (833) 774-6333

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion78
Laminectomy or laminotomy (partial removal of spine bones)74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1903771NYMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
True North Medical of Suffolk, PC Neurological Surgery CurrentSince Jun 9, 2024 Accepting new patients
Brain Care Long Island PLLC Neurological Surgery CurrentSince Feb 3, 2022 Accepting new patients

Locations

4681 Veterans Memorial Hwy
Holbrook, NY 11741
Phone (631) 482-9977

110 E Main St
Ste 2B
Huntington, NY 11743
Phone (631) 337-7698

1175 Montauk Hwy
Ste 6
West Islip, NY 11795
Phone (631) 422-5371

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1982674461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 MONTAUK HWY STE 6",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954939",
            "telephone_number": "833-666-6066",
            "fax_number": "631-337-7698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 MONTAUK HWY",
            "address_2": "STE 6",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954939",
            "telephone_number": "833-666-6066",
            "fax_number": "631-337-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "1903771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01924574",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00077933",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.