Alicia D McCullough, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2500090246 Issued in MO

Practice address

4400 Broadway Blvd Ste 300
Kansas City, MO 64111-3342

Phone

(816) 932-1711

NPI assigned

Jun 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, KS2 enrollments

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 2

Specialty

Psychiatry

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138

Merit-based Incentive Payment System (MIPS)

Final score

82.56 of 100Reported as group

Quality

76.07

Promoting interoperability

100

Improvement activities

40

Cost

65.79

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amccullough625172@direct.saint-lukes.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.

• Saint Luke'S Physician Group Inc

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1093263717

  KS

  Medicare reassignment Care Compare group NPD

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

• St Lukes Hospital of Kansas City

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1063494177
  Care Compare affiliation
• St Lukes Hospital of Kansas City

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1932642972
  Care Compare affiliation
• St. Luke'S Hospital of Kansas City

  • General Acute Care Hospital
  • Liberty, MO
  • NPI 1275926198
  Care Compare affiliation

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1689235301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST",
            "address_2": "MAILSTOP 400S",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64131",
            "telephone_number": "816-932-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 BROADWAY BLVD STE 300",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113342",
            "telephone_number": "816-932-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "ALICIA",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "0548330",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2500090246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meggan L McCue, AA
• Johanna Lynn McCullagh, MD
• Dawna McCulloch, MD
• Scott W McCulloch, MD
• Russell James McCulloh, MD
• Jennifer Lynn McCullough, MD
• Joseph E McCullough, M.D.
• Rebecca McCullough, PA-C
• Robert Michael McCullough, M.D.
• Wade McCumber

• Psychiatry Physician in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.