Individual provider Active NPI

Holly Cullen, M.D.

  • Gastroenterology Physician
  • Emerson, NJ
National Provider Identifier
1023048584
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MA53726 Issued in NJ
Practice address
466 Old Hook Rd
Suite 1
Emerson, NJ 07630-1396
Phone
(201) 967-8221
NPI assigned
Jul 3, 2006
Last updated
Jan 21, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MA53726 NJ Primary

Addresses

Primary practice location

466 Old Hook Rd
Suite 1
Emerson, NJ 07630-1396

Mailing address

466 Old Hook Rd
Suite 1
Emerson, NJ 07630-1396
Phone (201) 967-8221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120316000348 NJ Practitioner - Gastroenterology 2769477439 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Rutgers New Jersey Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MPV New Jersey MD Services PCGroup PAC ID 5991097669, 146 clinicians

Practice addresses (Care Compare)

466 Old Hook Rd
Emerson, NJ 07630-1368

622 Franklin Ave
Nutley, NJ 07110-1247
Phone (973) 661-1900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy31
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA53726NJMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Alliance LLC Gastroenterology CurrentSince Mar 10, 2014 Accepting new patients
MPV New Jersey MD Services PC CurrentSince Aug 1, 2017 Accepting new patients
MPV New Jersey MD Services PC CurrentSince Aug 1, 2017 Accepting new patients

Locations

466 Old Hook Rd
Ste 1
Emerson, NJ 07630
Phone (201) 261-0821

Interoperability endpoints

  • Direct secure messaging: hcullen189556@ahs.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1023048584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 OLD HOOK RD",
            "address_2": "SUITE 1",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301396",
            "telephone_number": "201-967-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 OLD HOOK RD",
            "address_2": "SUITE 1",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301396",
            "telephone_number": "201-967-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "HOLLY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "MA53726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emerson, NJ

Sources for this page

Verify at the official NPI Registry.