Patrick Harold McCullough, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

033428 Issued in NY

Practice address

1037 State Route 196
Hudson Falls, NY 12839-2168

Phone

(518) 747-9527

Fax

(518) 747-6151

NPI assigned

Feb 13, 2007

Sex

Male

Sole proprietor

Yes

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 NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Tri-County Eye Care and Optometry PC

  • Pediatric Optometrist
  • Hudson Falls, NY
  • NPI 1629124649
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629110705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 TRIPHAMMER RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128048064",
            "telephone_number": "518-798-3186",
            "fax_number": "518-798-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 STATE ROUTE 196",
            "city": "HUDSON FALLS",
            "state": "NY",
            "postal_code": "128392168",
            "telephone_number": "518-747-9527",
            "fax_number": "518-747-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "PATRICK",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "033428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laverne McAndrew, LCSW-R
• McCann Drug Co Inc
• McCann Drug Co Inc
• Richard Kevin McCann
• John McCloskey, PH.D,
• Erin M McMahon, M.S., BCBA, LBA
• Santosh Devaray Mesta
• Ashley Lynn Moffitt, LMHC
• Richard Edward Morey, LCSW-CASAC
• Monica Patricia Morris, MHC-LP

• General Practice Dentistry in Hudson Falls, NY
• Providers in Hudson Falls, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.