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TYSON JOHN MCMULLEN PA-C
NPI 1154006757
Physician Assistant in Walnut Creek, CA

Active since June 20, 2023PECOS Enrolled
1360 WALDEN RD, WALNUT CREEK, CA 94597(925) 324-1116 Get Directions Write a Review

NPPES record last updated: July 23, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jul 18, 2024, Jun 20, 2023 (2 updates tracked since 2023).

About Tyson John Mcmullen Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYSON JOHN MCMULLEN PA-C (NPI 1154006757) is an individual physician assistant in Walnut Creek, California, licensed in California (PA63707) and active in the NPI registry since June 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1154006757
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameTYSON JOHN MCMULLENCredential: PA-C
Location Address1360 WALDEN RDWalnut Creek, CA 94597-3158
Mailing Address1360 Walden RdWalnut Creek, CA 94597-3158 · (925) 324-1116
Phone(925) 324-1116
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJune 20, 2023
Last NPPES UpdateJuly 23, 20252 updates tracked since enumeration
NPPES CertifiedJuly 23, 2025
✔ NPI 1154006757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · PA63707
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1360 WALDEN RD, Walnut Creek, CA 94597
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tyson John Mcmullen Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3678071230
PECOS Enrollment IDI20250812003830
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94597 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyson Mcmullen's NPI number?

The NPI number for Tyson Mcmullen is 1154006757. It was assigned to this individual provider in the NPPES registry on June 20, 2023.

Where is Tyson Mcmullen located?

Tyson Mcmullen practices at 1360 Walden Rd, Walnut Creek, CA 94597. The listed phone number is (925) 324-1116.

What is Tyson Mcmullen's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Tyson Mcmullen enrolled in Medicare?

Yes. Tyson Mcmullen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tyson Mcmullen was last updated on July 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.