Active NPI
Ronald McCullough, PA
- Physician Assistant
- Brooklyn, NY
National Provider Identifier
1386689370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001146
- Practice address
- 506 Sixth Street
The Methodist Hospital
Brooklyn, NY 11215 - Phone
- (718) 780-3159
- Fax
- (610) 617-6280
- NPI assigned
- Jun 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001146 | NY | Primary |
Addresses
Primary practice location
506 Sixth Street
The Methodist Hospital
Brooklyn, NY 11215
Mailing address
PO Box 681
Van Brunt Station Park Slope Emergency Physician Servic
Brooklyn, NY 11215
Phone (800) 666-2455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01954530 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001146 | NY | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208476800000",
"number": "1386689370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 681",
"address_2": "VAN BRUNT STATION PARK SLOPE EMERGENCY PHYSICIAN SERVIC",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11215",
"telephone_number": "800-666-2455",
"fax_number": "610-617-6280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 SIXTH STREET",
"address_2": "THE METHODIST HOSPITAL",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11215",
"telephone_number": "718-780-3159",
"fax_number": "610-617-6280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCULLOUGH",
"first_name": "RONALD",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-17",
"last_updated": "2008-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "001146",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01954530",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.