Patricia M McCullough, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-002508 Issued in AZ

Practice address

167 Main Street
Tuba City, AZ 86045

Phone

(866) 976-5941

NPI assigned

Aug 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TX, AZ2 enrollments

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 2

Specialty

Optometry

Education

Southern California College of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Arizona Optometry PLLCGroup PAC ID 6901180587, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Northern Arizona Optometry, PLLC

  dba Eye Care Associates

  • Optometrist
  • Flagstaff, AZ
  • NPI 1326587577
  Medicare reassignment Care Compare group NPD
• Tuba City Regional Health Care Corporation

  dba Tuba City Indian Medical Center

  • General Acute Care Hospital
  • Tuba City, AZ
  • NPI 1548294424

  TX

  Medicare reassignment NPD
• Tuba City Regional Health Care Corporation

  dba Cameron Dental Clinic

  • Family Medicine Physician
  • Cameron, AZ
  • NPI 1134382211
  NPD
• Tuba City Regional Health Care Corporation

  dba Bodaway Gap Clinic

  • Family Medicine Physician
  • Bodaway Gap, AZ
  • NPI 1710519913
  NPD

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1689348054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860021000",
            "telephone_number": "928-310-6368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 MAIN STREET",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "86045",
            "telephone_number": "866-976-5941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Desktops",
            "affiliation": "N",
            "address_1": "167 Main Street",
            "city": "Tuba City",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "86045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Tuba",
            "affiliation": "N",
            "address_1": "167 Main Street",
            "city": "Tuba City",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "86045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Haneelia Jean Max
• Sophie Maxwell, RN
• Dyne Michael McAdam, RN
• Darlene Rebecca McAuliffe, RN
• Dusty Ray McCabe, C.N.A.
• Kathleen McDonald, PA-C
• Kathryn McDonald, R.N.
• Matthew Alan McGhee, CRNA
• Harry D McGinnity, DO
• Calvin Jude McIntyre, RN

• Optometrist in Tuba City, AZ
• Providers in Tuba City, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.