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GAVIN MCMULLEN CRNA
NPI 1720549504
Nurse Anesthetist, Certified Registered in San Bernardino, CA

Active since March 26, 2019Accepts Medicare Assignment
95/100
CMS Quality Rating
2101 N WATERMAN AVE, SAN BERNARDINO, CA 92404(909) 883-8711 Get Directions Write a Review

NPPES record last updated: March 26, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Gavin Mcmullen Crna NPPES

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

GAVIN MCMULLEN CRNA (NPI 1720549504) is an individual nurse anesthetist, certified registered in San Bernardino, California, licensed in California (125600) and active in the NPI registry since March 2019. He is a graduate of Loma Linda University School Of Medicine (2019).

NPPES Registry Identity

NPI1720549504
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameGAVIN MCMULLENCredential: CRNA
Location Address2101 N WATERMAN AVESan Bernardino, CA 92404-4836
Mailing Address29585 Chandler RdHighland, CA 92346-5415
Phone(909) 883-8711
Sole ProprietorNo
Medical School CMSLoma Linda University School Of MedicineGraduated 2019
Enumeration DateMarch 26, 2019
✔ NPI 1720549504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in CA · 125600
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
2101 N WATERMAN AVE, San Bernardino, CA 92404
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gavin Mcmullen Crna 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 ID5597098491
PECOS Enrollment IDI20190607002241

Medicare Billing Reassignments

6

Medicare enrollment records show Gavin Mcmullen reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Palm Springs Anesthesia Services, PC
Same address
Anesthesiology
2101 N WATERMAN AVE
San Bernardino, CA 92404
  • Reassigned Medicare billing, California enrollment
  • 270 clinicians in this Medicare group
NPI 1083928501 (914) 491-9495
Darin Rentz Do PC
7.9 mi
Anesthesiology
350 TERRACINA BLVD
Redlands, CA 92373
  • Reassigned Medicare billing, California enrollment
  • 241 clinicians in this Medicare group
NPI 1689321747 (877) 565-6701
Jp Anesthesia Inc
12 mi
Nurse Anesthetist, Certified Registered
4936 SNOWBERRY DR
Fontana, CA 92336
  • Reassigned Medicare billing, California enrollment
  • 55 clinicians in this Medicare group
NPI 1609590926 (909) 962-9440
Mission Nursing Anesthesia, Inc
55 mi
Nurse Anesthetist, Certified Registered
35800 BOB HOPE DR, SUITE 100
Rancho Mirage, CA 92270
  • Reassigned Medicare billing, California enrollment
  • 96 clinicians in this Medicare group
NPI 1932571551 (615) 620-2320
Sda Services Of Ca
648 mi
Anesthesiology
800 E WASHINGTON BLVD
Crescent City, CA 95531
  • Reassigned Medicare billing, California enrollment
  • 134 clinicians in this Medicare group
NPI 1417428970 (707) 464-8511
Sweet Dreams Anesthesia Inc
1,818 mi
Nurse Anesthetist, Certified Registered
2108 E 3RD ST
Chattanooga, TN 37404
  • Reassigned Medicare billing, California enrollment
  • 44 clinicians in this Medicare group
NPI 1508133497 (423) 267-0466

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92404 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
$136.04 typical visit price
range $59.60 – $179.42
Typical copayment $34.01 (range $14.90 – $44.85)
Most-billed visit code 99204
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality88.9
Improvement Activities40
Cost70.34

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.

NICHOLAS WALTHER PA-C
Physician Assistant (Medical)
2101 N WATERMAN AVE
SAN BERNARDINO, CA 92404
San Bernardino County (909) 883-8711
DR. GIAN CHRISTIAN TONGSON IGNACIO MD
Student in an Organized Health Care Education/Training Program
2101 N WATERMAN AVE
SAN BERNARDINO, CA 92404
San Bernardino County (818) 282-2085
FASIHA NAZIR
Student in an Organized Health Care Education/Training Program
2101 N WATERMAN AVE
SAN BERNARDINO, CA 92404
San Bernardino County (909) 883-8711
DEVAL DAVE PA
Physician Assistant
2101 N WATERMAN AVE
SAN BERNARDINO, CA 92404
San Bernardino County (909) 883-8711
ALYSSA HOGUE
Pharmacy Technician
2101 N WATERMAN AVE
SAN BERNARDINO, CA 92404
San Bernardino County (909) 883-8711
DR. ARIN VANESSA COLLIN MD
Student in an Organized Health Care Education/Training Program
2101 N WATERMAN AVE
SAN BERNARDINO, CA 92404
San Bernardino County (909) 883-8711
DAVID D. TITO M.D.
Emergency Medicine
2101 N WATERMAN AVE
SAN BERNARDINO, CA 92404
San Bernardino County (909) 883-8711
ROBERT DEVORE, JR., M.D., INC
Anesthesiology
2101 N WATERMAN AVE
SAN BERNARDINO, CA 92404
San Bernardino County (800) 883-7243

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 Gavin Mcmullen's NPI number?

The NPI number for Gavin Mcmullen is 1720549504. It was assigned to this individual provider in the NPPES registry on March 26, 2019.

Where is Gavin Mcmullen located?

Gavin Mcmullen practices at 2101 N Waterman Ave, San Bernardino, CA 92404. The listed phone number is (909) 883-8711.

What is Gavin Mcmullen's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Gavin Mcmullen enrolled in Medicare?

Yes. Gavin Mcmullen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Gavin Mcmullen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gavin Mcmullen reassigns Medicare benefits to 6 organizations: Palm Springs Anesthesia Services, PC (San Bernardino, CA), Darin Rentz Do PC (Redlands, CA), Jp Anesthesia Inc (Fontana, CA), Mission Nursing Anesthesia, Inc (Rancho Mirage, CA), Sda Services Of Ca (Crescent City, CA) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gavin Mcmullen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Gavin Mcmullen was last updated on March 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.