KENNETH H MULLEN (MD) – Family Medicine Physician, NPI 1922065721
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,194 FAMILY PRACTICE in CA
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Provider Addresses for KENNETH H MULLEN (MD)
Jack in the Box, 2425, West Kettleman Lane, Lodi, San Joaquin County, California, 95242, United States
LODI, CA 952419511
Phone: (209) 339-7435
Fax: (209) 339-7858
Type: Mailing
1901, West Kettleman Lane, Lodi, San Joaquin County, California, 95242, United States
# 200
LODI, CA 952424337
Phone: (209) 334-8540
Fax: (209) 368-2885
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $44.
Total Amount is formed as General ($44) + Research ($0) + Ownership ($0) = $44.
Last reported payment date: 2023-05-31 • Largest payer in this snapshot: ABIOMED ($44).
Total Amount
$44
General + Research + Ownership
Payments
1
Total payment records
General Amount
$44
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABIOMED | $44 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-03-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040302001025 | I | Family Practice | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 109 | 11 | $0 |
Insurance plans in this area (ZIP 95241)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | CA | |
| - | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| - | CA | |
| - | CA | |
| - | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| Internal Medicine | CA |
Reviews
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