Active NPI
Timothy Cullinan, D.C.
- Chiropractor
- Oyster Bay, NY
National Provider Identifier
1679632343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X009083-2
- Practice address
- 72 W Main St
Oyster Bay, NY 11771-2211 - Phone
- (516) 922-4606
- NPI assigned
- Dec 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X009083-2 | NY | Primary |
Addresses
Primary practice location
72 W Main St
Oyster Bay, NY 11771-2211
Mailing address
11 Chester St
Lake Grove, NY 11755-3045
Phone (631) 737-1022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C09083 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120130000505 | NY | Practitioner - Chiropractic | 6608033972 | Practice locations: Oyster Bay, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
72 W Main St
Oyster Bay, NJ 11771-2211
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X009083-2 | NY | MD | Chiropractor |
| 009083 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Timothy Cullinan DC PLLC | Chiropractor | Current | Accepting new patients |
Locations
72 W Main St
Oyster Bay, NY 11771
Phone (516) 922-4606
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.
-
- Chiropractor
- Oyster Bay, NY
- NPI 1831031152
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717459200000",
"number": "1679632343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 CHESTER ST",
"city": "LAKE GROVE",
"state": "NY",
"postal_code": "117553045",
"telephone_number": "631-737-1022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "72 W MAIN ST",
"city": "OYSTER BAY",
"state": "NY",
"postal_code": "117712211",
"telephone_number": "516-922-4606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CULLINAN",
"first_name": "TIMOTHY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-08",
"last_updated": "2024-06-04",
"certification_date": "2024-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X009083-2",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "C09083",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oyster Bay, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.