Individual provider Active NPI

Timothy J. McCulley, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Houston, TX
National Provider Identifier
1124044979
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
T2801 Issued in TX
Practice address
6400 Fannin St
Houston, TX 77030-1521
Phone
(713) 486-9400
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A60994 CA
Ophthalmology Physician 207W00000X D73128 MD
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X T2801 TX Primary

Addresses

Primary practice location

6400 Fannin St
Houston, TX 77030-1521

Mailing address

6400 Fannin St
Houston, TX 77030-1521

Other identifiers 1

IdentifierTypeStateIssuer
00A609940MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210819000895 TX Practitioner - OphthalmologyPractitioner - Optometry 9931001997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Washington University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 2961732193, 206 clinicians

Practice addresses (Care Compare)

11920 Astoria Blvd
Suite 292
Houston, TX 77089-6155
Phone (713) 486-7970

6411 Fannin St
Houston, TX 77030-1501
Phone (713) 704-4000

Hospital & facility affiliations

  • Memorial Hermann - Texas Medical Center Hospital, Houston, TX, CCN 450068

Merit-based Incentive Payment System (MIPS)

Final score
84.63 of 100Reported as group
Quality
68.75
Promoting interoperability
100
Improvement activities
40
Cost
72.66

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A60994CAMDOphthalmology Physician
D73128MDMDOphthalmology Physician
T2801TXMDOphthalmic Plastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Sep 1, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

6400 Fannin St
Houston, TX 77030
Phone (713) 704-4300

11920 Astoria Blvd
Ste 292
Houston, TX 77089
Phone (713) 486-7970

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1124044979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301521",
            "telephone_number": "713-486-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLEY",
        "first_name": "TIMOTHY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A60994",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D73128",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "T2801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A609940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.