Stephanie McCullough, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA64037 Issued in CA

Practice address

3104 Sunset Blvd Ste 2B
Rocklin, CA 95677-3093

Phone

(916) 624-0300

NPI assigned

Apr 19, 2024

Sex

Female

Sole proprietor

No

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 CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rocklin Family Practice and Sports MedicineGroup PAC ID 5395724777, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Assurance Home Care Home health agency, Sacramento, CA, CCN 059635
• Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
• Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: smccullough686081@hisp.ehr.sutterhealth.org

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.

• Rocklin Family Practice and Sports Medicine

  • Family Medicine Physician
  • Rocklin, CA
  • NPI 1790798908
  Medicare reassignment Care Compare group

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

• Assurance Health Partners Inc

  • Home Health Agency
  • Sacramento, CA
  • NPI 1740628460
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Roseville, CA
  • NPI 1356390264
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  Care Compare affiliation

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1497500995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 BELMONT DR",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956035516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 SUNSET BLVD STE 2B",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956773093",
            "telephone_number": "916-624-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "STEPHANIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Catherine McCarthy-Hamrick, SLP
• Julia Pearl McCasland
• Jordan McClintock
• Kaelani McCoin
• Carolina Arisbel McColl
• Cheyenne McCully
• Carmen Marie McDavitt, CMT, NMT
• Michael McDonald
• Kristine Lorraine Ann McDuff
• Dondrika Reshay McGee

• Physician Assistant in Rocklin, CA
• Providers in Rocklin, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.