NPIMap

Individual provider Active NPI

John D Cullen, M.D.

  • Neurology Physician
  • Rochester, NY
National Provider Identifier
1366761991
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
279385 Issued in NY
Practice address
2655 Ridgeway Ave
Suite 420
Rochester, NY 14626-4296
Phone
(585) 723-7972
NPI assigned
May 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X 279385 NY
Neurology Physician 2084N0400X 279385 NY Primary

Addresses

Primary practice location

2655 Ridgeway Ave
Suite 420
Rochester, NY 14626-4296

Mailing address

2655 Ridgeway Ave
Suite 420
Rochester, NY 14626-4296
Phone (585) 723-7972

Other practice location 1

739 Irving Ave Ste 340
Syracuse, NY 13210-1605
Phone (315) 470-7747

Other identifiers 1

IdentifierTypeStateIssuer
04187702MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jcullen@crousemed.medentdirect.com Direct Crouse Medical Practice, PLLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150819008560 NY Practitioner - Neurology 4587885470 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
State University of Ny Upstate Medical University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Unity Hospital of RochesterGroup PAC ID 9436060969, 732 clinicians

Practice addresses (Care Compare)

2655 Ridgeway Ave
Suite 420
Rochester, NY 14626-4296
Phone (585) 723-7972

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
279385NYMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Unity Hospital of Rochester CurrentSince Aug 1, 2015 Accepting new patients
Rochester General Hospital CurrentSince Feb 1, 2016 Accepting new patients
Rochester General Hospital CurrentSince Feb 1, 2016 Accepting new patients
Crouse Medical Practice PLLC CurrentSince Jun 10, 2018 Accepting new patients
Rochester General Hospital Current Accepting new patients
The Unity Hospital of Rochester Current Accepting new patients
Mid Hudson Physicians, P.C. CurrentSince Feb 10, 2017 Accepting new patients
Crouse Medical Practice, PLLC CurrentSince Jun 10, 2018 Accepting new patients
Crouse Health Inc. Past Accepting new patients
Rochester General Hospital Past Accepting new patients

Locations

396 Broadway
Kingston, NY 12401
Phone (845) 331-3131

2655 Ridgeway Ave
Ste 420
Rochester, NY 14626
Phone (585) 723-7705

1425 Portland Ave
Lbby
Rochester, NY 14621
Phone (585) 922-4111

1415 Portland Ave
Rochester, NY 14621
Phone (585) 275-7741

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

739 Irving Ave
Ste 340
Syracuse, NY 13210
Phone (315) 470-7747

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

Interoperability endpoints

  • Direct secure messaging: jcullen171150@direct.rochesterregional.org
  • Direct secure messaging: jcullen@crousemed.medentdirect.com

Organizations & group practices 10

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 10

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": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1366761991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 RIDGEWAY AVE",
            "address_2": "SUITE 420",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264296",
            "telephone_number": "585-723-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 RIDGEWAY AVE",
            "address_2": "SUITE 420",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264296",
            "telephone_number": "585-723-7972"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "739 Irving Ave Ste 340",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132101605",
            "country_code": "US",
            "telephone_number": "315-470-7747",
            "fax_number": "315-470-7758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-21",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NY",
            "license": "279385",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "279385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04187702",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcullen@crousemed.medentdirect.com",
            "affiliation": "Y",
            "endpointDescription": "email address in Medent",
            "affiliationName": "Crouse Medical Practice, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "739 Irving Ave Ste 340",
            "city": "Syracuse",
            "state": "NY",
            "country_code": "US",
            "postal_code": "132101605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.