Individual provider Active NPI

Jennifer R McCullen, MD

  • Gynecology Physician
  • Lakewood Ranch, FL
National Provider Identifier
1497756944
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
0066257 Issued in FL
Practice address
8340 Lakewood Ranch Blvd
Ste 240
Lakewood Ranch, FL 34202-5180
Phone
(941) 907-3008
Fax
(941) 907-3036
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 0066257 FL
Gynecology Physician 207VG0400X 0066257 FL Primary

Addresses

Primary practice location

8340 Lakewood Ranch Blvd
Ste 240
Lakewood Ranch, FL 34202-5180

Mailing address

8340 Lakewood Ranch Blvd
Ste 240
Lakewood Ranch, FL 34202-5180
Phone (941) 907-3008

Other identifiers 1

IdentifierTypeStateIssuer
376538500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20101004000103 FL Practitioner - Obstetrics/Gynecology 7315139854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Tufts University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Woman Care LLCGroup PAC ID 5395807218, 607 clinicians

Practice addresses (Care Compare)

8340 Lakewood Ranch Blvd
Suite 240
Lakewood Ranch, FL 34202-5185
Phone (941) 907-3008

Hospital & facility affiliations

  • Lakewood Ranch Medical Center Hospital, Bradenton, FL, CCN 100299
  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
Quality
84.84
Promoting interoperability
100
Improvement activities
40
Cost
77.7

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

Organizations & group practices 1

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 2

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1497756944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8340 LAKEWOOD RANCH BLVD",
            "address_2": "STE 240",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025180",
            "telephone_number": "941-907-3008",
            "fax_number": "941-907-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8340 LAKEWOOD RANCH BLVD",
            "address_2": "STE 240",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025180",
            "telephone_number": "941-907-3008",
            "fax_number": "941-907-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLEN",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "0066257",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "0066257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376538500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

Verify at the official NPI Registry.