Individual provider Active NPI

Michael A McCulloch, MD

  • Pediatric Cardiology Physician
  • Charlottesville, VA
National Provider Identifier
1033324488
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
0101262131 Issued in VA
Practice address
1215 Lee St
Charlottesville, VA 22908-2824
Phone
(434) 924-0211
NPI assigned
May 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 0101262131 VA
Pediatric Cardiology Physician 2080P0202X 0101262131 VA Primary

Addresses

Primary practice location

1215 Lee St
Charlottesville, VA 22908-2824

Mailing address

1215 Lee St
Charlottesville, VA 22908-2824
Phone (434) 924-0211

Other practice location 1

1204 W Main St
Charlottesville, VA 22903-2824
Phone (434) 924-0123

Other practice location 2

4348 Electric Rd
Roanoke, VA 24018-0720
Phone (540) 769-0976

Other identifiers 2

IdentifierTypeStateIssuer
4144660-00MedicaidMD
102117382MedicaidPA

Electronic endpoints 5

TypeEndpointUseAffiliation
Direct Messaging Address mmcculloch338399@direct.healthsystem.virginia.edu Direct
Direct Messaging Address mmcculloch338399@direct.healthsystem.virginia.edu
Direct Messaging Address mmcculloch338399@direct.healthsystem.virginia.edu
Direct Messaging Address mmcculloch338399@direct.healthsystem.virginia.edu Direct
Direct Messaging Address mmcculloch338399@direct.healthsystem.virginia.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20170622001644 VA Practitioner - Pediatric Medicine 3274837638 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Texas Medical School at San Antonio, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Virginia Physicians GroupGroup PAC ID 4880590728, 1,685 clinicians

Practice addresses (Care Compare)

1204 W Main St
FL 6
Charlottesville, VA 22903-2824
Phone (434) 924-5321

Hospital & facility affiliations

  • University of Virginia Medical Center Hospital, Charlottesville, VA, CCN 490009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101262131VAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Medical Center Current Accepting new patients
Warren Memorial Hospital, Inc. CurrentSince Dec 15, 2018 Accepting new patients
Shenandoah Memorial Hospital, Inc. CurrentSince Dec 11, 2018 Accepting new patients
Shenandoah Memorial Hospital Inc. CurrentSince Dec 11, 2018 Accepting new patients
Page Memorial Hospital, Inc. CurrentSince Dec 15, 2018 Accepting new patients
Carilion Medical Center CurrentSince Oct 6, 2024 Accepting new patients
Page Memorial Hospital, Inc. CurrentSince Dec 15, 2018 Accepting new patients
Winchester Medical Center CurrentSince Dec 11, 2018 Accepting new patients
Winchester Medical Center CurrentSince Dec 11, 2018 Accepting new patients
Warren Memorial Hospital, Inc. CurrentSince Dec 15, 2018 Accepting new patients
University of Virginia Physicians Group CurrentSince Jun 1, 2017 Accepting new patients
Shenandoah Memorial Hospital, Inc. Current Accepting new patients
Carilion Medical Center CurrentSince Oct 6, 2024 Accepting new patients
Shenandoah Memorial Hospital, Inc. Past Accepting new patients

Locations

1204 W Main St
Charlottesville, VA 22903
Phone (434) 924-0123

1204 W Main St
Fl 6
Charlottesville, VA 22903
Phone (434) 924-0123

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

1000 N Shenandoah Ave
Front Royal, VA 22630
Phone (540) 636-0300

351 Valley Health Way
Front Royal, VA 22630
Phone (540) 636-0300

200 Memorial Dr
Luray, VA 22835
Phone (540) 743-4561

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

4348 Electric Rd
Roanoke, VA 24018
Phone (540) 769-0600

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

759 S Main St
Woodstock, VA 22664
Phone (540) 459-1100

240 Shenandoah St
Woodstock, VA 22664
Phone (540) 459-2808

Interoperability endpoints

  • Direct secure messaging: mmcculloch338399@direct.healthsystem.virginia.edu

Organizations & group practices 14

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

View all 14

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": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1033324488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229082824",
            "telephone_number": "434-924-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229082824",
            "telephone_number": "434-924-0211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1204 W Main St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229032824",
            "country_code": "US",
            "telephone_number": "434-924-0123",
            "fax_number": "434-243-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4348 Electric Rd",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240180720",
            "country_code": "US",
            "telephone_number": "540-769-0976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCULLOCH",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "VA",
            "license": "0101262131",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "VA",
            "license": "0101262131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4144660-00",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102117382",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmcculloch338399@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1204 W Main St",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229032824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmcculloch338399@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "address_1": "1000 N Shenandoah Ave",
            "city": "Front Royal",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226303547",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmcculloch338399@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "address_1": "1840 Amherst St",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226012808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmcculloch338399@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 Memorial Dr",
            "city": "Luray",
            "state": "VA",
            "country_code": "US",
            "postal_code": "228351000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmcculloch338399@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "address_1": "759 S Main St",
            "city": "Woodstock",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226641154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.