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JENNIFER LYNN MULLALLY MD
NPI 1871814863
Pediatrics in Fargo, ND

Active since June 14, 2010PECOS Enrolled
82.99/100
CMS Quality Rating
1702 UNIVERSITY DR S, FARGO, ND 58103(701) 364-3300(701) 364-8906 Get Directions Write a Review

NPPES record last updated: November 11, 2013. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Jennifer Lynn Mullally Md NPPES

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

JENNIFER LYNN MULLALLY MD (NPI 1871814863) is an individual pediatrics provider in Fargo, North Dakota, licensed in North Dakota (12728) and active in the NPI registry since June 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1871814863
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameJENNIFER LYNN MULLALLYCredential: MD
Location Address1702 UNIVERSITY DR SFargo, ND 58103-4940
Mailing AddressPo Box 6001Fargo, ND 58108-6001 · (701) 364-3300 · Fax (701) 364-8906
Phone(701) 364-3300
Fax(701) 364-8906
Sole ProprietorNo
Enumeration DateJune 14, 2010
Last NPPES UpdateNovember 11, 2013
✔ NPI 1871814863 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in ND · 12728✔ Licensed in MN · 54202
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1702 UNIVERSITY DR S, Fargo, ND 58103
Open in Google Maps ↗

Other Identifiers 3

Medicaid18249ND
Medicare PIN370004504MN
Medicare PINN719060ND

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Medica, Sanford Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Lynn Mullally Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 58103 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
$85.71 typical visit price
range $55.75 – $168.12
Typical copayment $21.42 (range $13.93 – $42.03)
Most-billed visit code 99203
Established Patient
$98.29 typical visit price
range $18.11 – $137.65
Typical copayment $24.57 (range $4.52 – $34.41)
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.

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.

82.99/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality87.06
Promoting Interoperability99
Improvement Activities40
Cost57.08

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.

BANGALORE S VIJAYALAKSHMI MD
Physical Medicine & Rehabilitation
1702 UNIVERSITY DR S
FARGO, ND 58103
Cass County (701) 364-3300
ANNIE LARSON RN, CDE
Registered Nurse (Diabetes Educator)
1702 UNIVERSITY DR S
FARGO, ND 58103
Cass County (701) 364-8000
TODD L METZGER OD
Optometrist
1702 UNIVERSITY DR S
FARGO, ND 58103
Cass County (701) 364-3300
CHRISTIAN J SORENSEN MD
Internal Medicine
1702 UNIVERSITY DR S
FARGO, ND 58103
Cass County (701) 364-3300
BESS J. MARTIN PHD, LP
Clinical Neuropsychologist
1702 UNIVERSITY DR S
FARGO, ND 58103
Cass County (701) 364-3300
DONG KIM MD
Dermatology
1702 UNIVERSITY DR S
FARGO, ND 58103
Cass County (701) 364-3300
NICOLE RENAE BOUCHER SLP
Speech-Language Pathologist
1702 UNIVERSITY DR S
FARGO, ND 58103
Cass County (701) 364-3300
LAURA MORRIS
Pharmacist
1702 UNIVERSITY DR S
FARGO, ND 58103
Cass County (701) 364-3450

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 Jennifer Mullally's NPI number?

The NPI number for Jennifer Mullally is 1871814863. It was assigned to this individual provider in the NPPES registry on June 14, 2010.

Where is Jennifer Mullally located?

Jennifer Mullally practices at 1702 University Dr S, Fargo, ND 58103. The listed phone number is (701) 364-3300.

What is Jennifer Mullally's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jennifer Mullally enrolled in Medicare?

Yes. Jennifer Mullally is registered in the Medicare PECOS enrollment system.

What insurance does Jennifer Mullally accept?

Health plans from Blue Cross Blue Shield of North Dakota, Medica, Sanford Health Plan and Security Health Plan list Jennifer Mullally as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jennifer Mullally was last updated on November 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.