Individual provider Active NPI

Noreen S Cullum, PA

  • Physician Assistant
  • Ann Arbor, MI
National Provider Identifier
1023229598
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003711 Issued in MI
Practice address
1500 E Medical Center Dr
3Rd Floor Taubman Center Recp B
Ann Arbor, MI 48109-5000
Phone
(734) 936-5582
NPI assigned
May 25, 2007
Last updated
Feb 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601003711 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
3Rd Floor Taubman Center Recp B
Ann Arbor, MI 48109-5000

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108-1633
Phone (734) 936-2047

Other identifiers 1

IdentifierTypeStateIssuer
5601003711OtherMIPHYSICIANS ASSISTANT LICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081204000424 MI Practitioner - Physician Assistant 8123189586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

1801 Briarwood Cir
Ann Arbor, MI 48108-3347
Phone (734) 539-5000

4250 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (734) 764-0231

4260 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (734) 936-4000

4270 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (734) 936-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Physician Assistant CurrentSince Dec 31, 2014 Accepting new patients
Regents of the University of Michigan CurrentSince Dec 31, 2014 Accepting new patients
Regents of the University of Michigan Past Accepting new patients
Downriver Rehabilitation Associates PC Past Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

1500 E Medical Center Dr
Fl 3
Ann Arbor, MI 48109
Phone (734) 647-5944

1801 Briarwood Cir
Ann Arbor, MI 48108
Phone (734) 539-5000

3621 S State St
#700
Ann Arbor, MI 48108

Interoperability endpoints

  • Direct secure messaging: ncullum60381@direct.hfhs.org

Organizations & group practices 5

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 1

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": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422835200000",
    "number": "1023229598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "address_2": "3RD FLOOR TAUBMAN CENTER RECP B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLUM",
        "first_name": "NOREEN",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2015-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS ASSISTANT LICE",
            "identifier": "5601003711",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.