Individual provider Active NPI

Julie Ann McCullough, MD

  • Obstetrics & Gynecology Physician
  • Peabody, MA
National Provider Identifier
1407802192
Registry record updated Jul 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
150570 Issued in MA
Practice address
3 Centennial Dr
Suite 250
Peabody, MA 01960-7931
Phone
(978) 531-4200
Fax
(978) 532-0211
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 150570 MA Primary

Addresses

Primary practice location

3 Centennial Dr
Suite 250
Peabody, MA 01960-7931

Mailing address

3 Centennial Dr
Suite 250
Peabody, MA 01960-7931
Phone (978) 531-4200

Other identifiers 1

IdentifierTypeStateIssuer
3157083MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20040310000350 MA Practitioner - Obstetrics/Gynecology 3971491929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Boston University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Gynecology, PCGroup PAC ID 9830367564, 3 clinicians

Practice addresses (Care Compare)

3 Centennial Dr
Peabody, MA 01960-7931
Phone (978) 531-4200

Hospital & facility affiliations

  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Diagnostic Services, Inc CurrentSince Jul 14, 2011 Accepting new patients

Locations

383 Paradise Rd
Swampscott, MA 01907
Phone (781) 599-1745

Interoperability endpoints

  • Direct secure messaging: mccullough.julie.nsg@direct.partners.masshiway.net

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 3

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310169600000",
    "number": "1407802192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CENTENNIAL DR",
            "address_2": "SUITE 250",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019607931",
            "telephone_number": "978-531-4200",
            "fax_number": "978-532-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CENTENNIAL DR",
            "address_2": "SUITE 250",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019607931",
            "telephone_number": "978-531-4200",
            "fax_number": "978-532-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2011-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "150570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3157083",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.