Individual provider Active NPI

Kathryn Eva Cullen, D.O.

  • Internal Medicine Physician
  • Summit, NJ
National Provider Identifier
1437337219
Registry record updated Apr 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MB08344900 Issued in NJ
Practice address
99 Beauvoir Ave
Summit, NJ 07901-3533
Phone
(866) 251-0094
NPI assigned
Feb 4, 2008
Last updated
Apr 16, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MB08344900 NJ Primary

Addresses

Primary practice location

99 Beauvoir Ave
Summit, NJ 07901-3533

Mailing address

651 W Mount Pleasant Ave
Livingston, NJ 07039-1600
Phone (866) 251-0094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20080407000073 NJ Practitioner - Internal Medicine 5698852341 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB08344900NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, P.C. Internal Medicine CurrentSince Feb 1, 2022 Accepting new patients
Rwjbh Emergency Medicine Associates, LLC Internal Medicine CurrentSince Nov 30, 2020 Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Feb 1, 2022 Accepting new patients

Locations

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

350 Forsgate Dr
Ste 103
Monroe Twp, NJ 08831
Phone (609) 831-0779

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

201 Lyons Ave
#M
Newark, NJ 07112
Phone (800) 843-2384

1 Plainsboro Rd
Plainsboro, NJ 08536
Phone (609) 853-7000

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880

Interoperability endpoints

  • Direct secure messaging: kmcdowell46051@epicdirect.rwjbh.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302912000000",
    "number": "1437337219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 W MOUNT PLEASANT AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070391600",
            "telephone_number": "866-251-0094",
            "fax_number": "973-251-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 BEAUVOIR AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013533",
            "telephone_number": "866-251-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLEN",
        "first_name": "KATHRYN",
        "middle_name": "EVA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-04",
        "last_updated": "2011-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB08344900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.