NPIMap

Individual provider Active NPI

Edward Thomas Cullen, MD

  • Internal Medicine Physician
  • Oxon Hill, MD
National Provider Identifier
1083775126
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0026607 Issued in MD
Practice address
6188 Oxon Hill Road
Suite 704
Oxon Hill, MD 20745-3151
Phone
(301) 839-2790
Fax
(301) 839-3042
NPI assigned
Dec 13, 2006
Last updated
Mar 4, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0026607 MD Primary
Internal Medicine Physician 207R00000X MD13637 DC

Addresses

Primary practice location

6188 Oxon Hill Road
Suite 704
Oxon Hill, MD 20745-3151

Mailing address

6188 Oxon Hill Road
Suite 704
Oxon Hill, MD 20745-3151
Phone (301) 839-2790

Other identifiers 4

IdentifierTypeStateIssuer
144561OtherUNITED HEALTH CARE
4086948OtherAETNA
0202OtherBCBS NATL CAPITOL AREA
41238504OtherBCBS OF MARYLAND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110415000034 DC Practitioner - Internal Medicine 0840330874 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Georgetown University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amber Hill Physical Therapy IncGroup PAC ID 8527963917, 336 clinicians
Privia Care Center LLCGroup PAC ID 3274801139, 286 clinicians

Practice addresses (Care Compare)

187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503

4910 Massachusetts Ave NW
Suite 114 Grady DC Office
Washington, DC 20016-4384
Phone (202) 686-0813

6410 Rockledge Dr
Suite 600
Bethesda, MD 20817-1844

7625 Wisconsin Ave
Suite 101
Bethesda, MD 20814-6564
Phone (301) 951-0420

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0026607MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Internal Medicine CurrentSince Jul 28, 2016 Accepting new patients
Privia Care Center LLC Internal Medicine CurrentSince Oct 4, 2018 Accepting new patients
Privia Care Center LLC Internal Medicine CurrentSince Oct 4, 2018 Accepting new patients
Privia Medical Group, LLC CurrentSince Jul 28, 2016 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4910 Massachusetts Ave NW
Ste 114
Washington, DC 20016
Phone (202) 244-0812

7625 Wisconsin Ave
Ste 101
Bethesda, MD 20814
Phone (240) 497-1570

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

Interoperability endpoints

  • Direct secure messaging: edward.cullen.1@8042.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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 6

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1083775126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6188 OXON HILL ROAD",
            "address_2": "SUITE 704",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453151",
            "telephone_number": "301-839-2790",
            "fax_number": "301-839-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6188 OXON HILL ROAD",
            "address_2": "SUITE 704",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453151",
            "telephone_number": "301-839-2790",
            "fax_number": "301-839-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "EDWARD",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0026607",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD13637",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "144561",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4086948",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NATL CAPITOL AREA",
            "identifier": "0202",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MARYLAND",
            "identifier": "41238504",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxon Hill, MD

Sources for this page

Verify at the official NPI Registry.