DR. MATTHEW TRAVIS MULLANE (MD MPH) – Family Medicine Physician, NPI 1720408479
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. MATTHEW TRAVIS MULLANE (MD MPH)
8510 BRYANT ST
STE 200
WESTMINSTER, CO 800313844
Phone: (303) 430-6002
Type: Mailing
14300 ORCHARD PKWY
WESTMINSTER, CO 800239206
Phone: (303) 430-5560
Fax: (303) 530-5565
Type: Location
62472 QUAIL RIDGE RD
BEND, OR 977019553
Phone:
Type: Mailing
711 NE IRVING AVE
BEND, OR 977014738
Phone: (541) 255-1530
Fax: (541) 219-5356
Type: Location
340 NW 5th St Ste 202
Redmond, OR 977561869
Phone: (541) 504-2218
Type: Location
62472 Quail Ridge Rd
Bend, OR 977019553
Phone: (541) 255-1530
Fax: (541) 219-5356
Type: Location
1333 NW 9th St
Prineville, OR 977541482
Phone: (541) 447-2631
Type: Location
1116 NE ULYSSES DR
BEND, OR 977013967
Phone: (541) 255-1530
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2018-10-30
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 |
|---|---|---|---|---|
| I20181030003373 | I | Family Practice | OR | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 80031)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | OR | |
| - | OR | |
| Nurse Practitioner | OR | |
| Physician Assistant | OR | |
| Internal Medicine | OR | |
| - | OR | |
| Nurse Practitioner | OR | |
| Clinical Social Worker | OR | |
| Nurse Practitioner | WA | |
| Family Practice | OR |
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