KELLY LOUISE MULLEN – Family Medicine Physician, NPI 1669992228
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
53 OSTEOPATHIC MANIPULATIVE MEDICINE in IN
Provider Addresses for KELLY LOUISE MULLEN
750 Broadway Ste 350
Fort Wayne, IN 468021412
Phone: (260) 423-2675
Fax: (260) 423-6621
Type: Location
Pointe Inverness Way, Covington Dells, Fort Wayne, Allen County, Indiana, 46804, United States
FORT WAYNE, IN 468047934
Phone: (260) 479-3513
Fax: (260) 479-3520
Type: Mailing
605, North Walnut Street, North Manchester, Wabash County, Indiana, 46962, United States
NORTH MANCHESTER, IN 469621857
Phone: (260) 982-1994
Fax: (260) 479-2936
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $155.
Total Amount is formed as General ($155) + Research ($0) + Ownership ($0) = $155.
Last reported payment date: 2024-06-05 • Largest payer in this snapshot: Axsome Therapeutics, Inc. ($118).
Total Amount
$155
General + Research + Ownership
Payments
3
Total payment records
General Amount
$155
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Axsome Therapeutics, Inc. | $118 |
| Inspire Medical Systems, Inc. | $24 |
| Lilly USA, LLC | $13 |
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: 2024-07-12
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 |
|---|---|---|---|---|
| I20240712002223 | I | Osteopathic Manipulative Medicine | WA | 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 |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 403 | 177 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 378 | 180 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 158 | 158 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 113 | 79 | $0 |
| G0008 | Administration of influenza virus vaccine | 37 | 36 | $0 |
Insurance plans in this area (ZIP 46802)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | TN | |
| Internal Medicine, Infectious Disease | PA | |
| Internal Medicine | WA | |
| Diagnostic Radiology | OR | |
| Internal Medicine | OR | |
| O P H T H A L M O L O G Y | IA | |
| - | OR | |
| Nurse Practitioner | WA | |
| Nurse Practitioner | WA | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | CA |
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