MALLORY PAIGE MULLIKIN NP
NPI 1235620592
Nurse Practitioner - Family in Petaluma, CA

Q: What is Mallory Mullikin's NPI number?

The NPI number for Mallory Mullikin is 1235620592. It was assigned to this individual provider in the NPPES registry on May 22, 2018.

Q: What is Mallory Mullikin's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Mallory Mullikin was last updated on September 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 22, 2018PECOS EnrolledAccepts Medicare Assignment

3900 LAKEVILLE HWY, PETALUMA, CA 94954(707) 765-3900 Get Directions Write a Review

NPPES record last updated: September 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 21, 2022, Nov 9, 2021, Feb 4, 2021 and 3 more (6 updates tracked since 2018).

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About Mallory Paige Mullikin Np NPPES

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

MALLORY PAIGE MULLIKIN NP (NPI 1235620592) is an individual family provider in Petaluma, California, licensed in California (95008697) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1235620592

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMALLORY PAIGE MULLIKINCredential: NP

Location Address3900 LAKEVILLE HWYPetaluma, CA 94954-5698

Mailing Address3900 Lakeville HwyPetaluma, CA 94954-5698 · (707) 765-3900

Phone(707) 765-3900

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateMay 22, 2018

Last NPPES UpdateSeptember 21, 20226 updates tracked since enumeration

NPPES CertifiedSeptember 21, 2022

✔ NPI 1235620592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 95008697

3900 LAKEVILLE HWY, Petaluma, CA 94954

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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 and accepts Medicare assignment

Mallory Paige Mullikin Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1557618808

PECOS Enrollment IDI20180718002358

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 94954 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

$96.16 typical visit price

range $63.04 – $187.01

Typical copayment $24.04 (range $15.76 – $46.75)

Most-billed visit code 99203

Established Patient

$109.88 typical visit price

range $21.02 – $153.40

Typical copayment $27.47 (range $5.25 – $38.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers37 claims87 services$5.68 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

8 suppliers17 claims21 services$0.81 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress E0295

DME-Hospital Beds · category DB000N

1 supplier15 claims16 services$51.84 avg. paid by Medicare

Bed side rails, half length E0305

DME-Hospital Beds · category DB000N

1 supplier15 claims30 services$7.93 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers24 claims24 services$200.49 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIEL G WHITE MD

Family Medicine