Gerald Thomas McCullough, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

43325 Issued in MN

Practice address

750 E 34TH St
Hibbing, MN 55746-2341

Phone

(218) 262-4881

Fax

(218) 362-6699

NPI assigned

Feb 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Diagnostic Radiology

Education

University of Minnesota Medical School, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiologists Associated in Duluth LTDGroup PAC ID 4284547209, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Memorial Hospital Hospital, Cloquet, MN, CCN 241364

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Astera Health

  • Rural Health Clinic/Center
  • Bertha, MN
  • NPI 1134115942

  Corporate Director

  CMS ownership
• Astera Health

  • Rural Health Clinic/Center
  • Wadena, MN
  • NPI 1134305162

  Corporate Director

  CMS ownership

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.

• Radiologists Associated in Duluth LTD

  • Diagnostic Radiology Physician
  • Hibbing, MN
  • NPI 1598722688
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community Memorial Hospital Association

  • Critical Access Hospital
  • Cloquet, MN
  • NPI 1003869082
  Care Compare affiliation

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1376679506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 W CENTRAL ENTRANCE # 160",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558113433",
            "telephone_number": "218-722-3700",
            "fax_number": "218-722-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E 34TH ST",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557462341",
            "telephone_number": "218-262-4881",
            "fax_number": "218-362-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "GERALD",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "43325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashton Whitney Martin, RN
• Mary Gargano Adult Foster Care
• Matt M. Anzelc DDS PA
• Laura Maxwell, LICSW
• Janean Marie McCue, CNP
• Amanda J McDonald, M.D.
• Andrew William McKibben, MD
• Medical Imaging North PA
• Medical Imaging North PA
• Stephen Menke

• Diagnostic Radiology Physician in Hibbing, MN
• Providers in Hibbing, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• 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.