MARY MULLEN-WALSH (CRNP) – Family Nurse Practitioner, NPI 1104811140

MARY MULLEN-WALSH (CRNP) is a healthcare provider. based in Scranton, Pennsylvania. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. VP005831B (PA). The NPI Number for MARY MULLEN-WALSH (CRNP) is 1104811140

Main info

Female
38 Years Of Experience
Accepts Medicare Assignment
Name
MARY MULLEN-WALSH (CRNP)
NPI
1104811140
Phone
(570) 344-3788
Address
5 MORGAN HWY
Enumeration Date
15 September 2005
Last Update Date
24 January 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5703443788
Graduation Year
1988 (38 years ago)
PAC ID
6406818368
Group Practice PAC ID
5193714723
Professional Enrollment ID
I20041102000932
Address ID
PA185082641SC5XXXXHWYX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

11,473 NURSE PRACTITIONER in PA

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Provider Addresses for MARY MULLEN-WALSH (CRNP)

  • 5, Morgan Highway, Scranton, Lackawanna County, Pennsylvania, 18508, United States

    SUITE 4

    SCRANTON, PA 185082641

    Phone: (570) 344-3788

    Fax: (570) 969-9280

    Mailing address matches the actual address.

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: 2004-11-02

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20041102000932INurse PractitionerPATBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes125122$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes9271$0
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes5545$0
View full utilization report →

Insurance plans in this area (ZIP 18508)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5193714723View full group profile
NameSpecialtyState
Physical Medicine And RehabilitationPA
Physical Medicine And RehabilitationPA
-PA
Physical Medicine And RehabilitationPA
Physical Medicine And Rehabilitation, Pain ManagementPA
Physician AssistantPA
Physical Therapist In Private PracticePA
Nurse PractitionerPA
Physician AssistantPA
Physical Medicine And RehabilitationPA

Reviews

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Frequently asked questions

What NPI should I save for MARY MULLEN-WALSH (CRNP)?
Save NPI 1104811140 if you need a stable reference for MARY MULLEN-WALSH (CRNP).
Is MARY MULLEN-WALSH (CRNP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is MARY MULLEN-WALSH (CRNP)?
The page reflects Family Nurse Practitioner for MARY MULLEN-WALSH (CRNP). Clinical services aligned with this taxonomy classification.
Does MARY MULLEN-WALSH (CRNP) practice in Pennsylvania?
You will see Scranton, Pennsylvania on file for MARY MULLEN-WALSH (CRNP) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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