Larry D McCullum

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1005 North Washington Avenue
Green Brook, NJ 08812

Phone

(732) 968-8900

NPI assigned

Sep 1, 2025

Last updated

Jan 21, 2026By the provider in NPPES

Sex

Male

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 NJ

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

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1039

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.

• Medemerge LLC

  dba Medemerge Medical Associates, PA

  • Primary Care Clinic/Center
  • Green Brook, NJ
  • NPI 1366656431
  Medicare reassignment NPD
• Medemerge P.a.

  • Family Medicine Physician
  • Green Brook, NJ
  • NPI 1184643132
  NPD

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

{
    "created_epoch": "1756684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1669351896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 MORRIS LANE",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "08854",
            "telephone_number": "732-425-1421",
            "fax_number": "732-425-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 NORTH WASHINGTON AVENUE",
            "city": "GREEN BROOK",
            "state": "NJ",
            "postal_code": "08812",
            "telephone_number": "732-968-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLUM",
        "first_name": "LARRY",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-01",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonard Siskin, P.a. (Siskin Family Chiropractic)
• Leonard Siskin, P.a. (Siskin Family Chiropractic)
• Live Comfort Home Care Inc
• Sriniwasan Mani
• Ansel Mathew, PHARMD
• Medemerge LLC (Medemerge Medical Associates, PA)
• Medemerge P.a.
• Medemerge PA (Medemerge)
• Medexpress Urgent Care - New Jersey, Inc (MedExpress Urgent Care - Green Brook)
• Mega Care Inc. (Greenbrook Manor)

• Physician Assistant in Green Brook, NJ
• Providers in Green Brook, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; 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.