Individual provider Active NPI

Maryann McCullough Nikander, AUD

  • Audiologist-Hearing Aid Fitter
  • Warminster, PA
National Provider Identifier
1053414920
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
AT-000394-L Issued in PA
Practice address
65 W Street Rd
Suite B-104
Warminster, PA 18974-3226
Phone
(215) 672-4327
Fax
(215) 646-0565
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X AT-000394-L PA Primary

Addresses

Primary practice location

65 W Street Rd
Suite B-104
Warminster, PA 18974-3226

Mailing address

65 W Street Rd
Suite B-104
Warminster, PA 18974-3226
Phone (215) 672-4327

Other identifiers 2

IdentifierTypeStateIssuer
1770752511OtherGROUP NPI
130578OtherMEDICARE PTAN

Other names 1

  • Maryann D McCullough Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080507000512 PA Practitioner - Qualified Audiologist 9638258213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rise Audiology, LLCGroup PAC ID 9739598137, 14 clinicians

Practice addresses (Care Compare)

65 W St Rd
Suite B104
Warminster, PA 18974-3216
Phone (215) 672-4327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT-000394-LPAMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Rise Audiology, LLC Audiologist-Hearing Aid Fitter CurrentSince Apr 1, 2021 Accepting new patients
Rise Audiology, LLC CurrentSince Apr 1, 2021 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

100 W Main St
Ste 105
Lansdale, PA 19446
Phone (215) 855-4217

65 W Street Rd
Ste B104
Warminster, PA 18974
Phone (215) 672-4327

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1053414920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 W STREET RD",
            "address_2": "SUITE B-104",
            "city": "WARMINSTER",
            "state": "PA",
            "postal_code": "189743226",
            "telephone_number": "215-672-4327",
            "fax_number": "215-646-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 W STREET RD",
            "address_2": "SUITE B-104",
            "city": "WARMINSTER",
            "state": "PA",
            "postal_code": "189743226",
            "telephone_number": "215-672-4327",
            "fax_number": "215-646-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKANDER",
        "first_name": "MARYANN",
        "middle_name": "MCCULLOUGH",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "PA",
            "license": "AT-000394-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1770752511",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "130578",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYANN",
            "last_name": "MCCULLOUGH",
            "middle_name": "D",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Warminster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.