Kimberly Marie McCullough, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00833200 Issued in NJ

Practice address

66 W Jimmie Leeds Rd # RS
Galloway, NJ 08205-9401

Phone

(609) 748-9100

NPI assigned

Feb 22, 2024

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

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physiatry Consultants of NJ LLCGroup PAC ID 3375914419, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Physiatry Consultants of NJ LLC

  • Physical Medicine & Rehabilitation Physician
  • Morton Grove, IL
  • NPI 1710690631

  NJ

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1689430258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 PENNANT AVE",
            "city": "BEACHWOOD",
            "state": "NJ",
            "postal_code": "087223933",
            "telephone_number": "848-333-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 W JIMMIE LEEDS RD # RS",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059401",
            "telephone_number": "609-748-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-22",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00833200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Shana Mattson, R.PH.
• Emily Ann Maul, M.S.ED CCC-SLP
• Christine Mayer, LSW
• Bridgette McCabe, M.D.
• Emily Anne McCall, LSW
• Danielle McDevitt, RD, LDN
• Yvette McDonald, LCADC
• Cailey McGloin, MOT, OTR/L
• Rebecca McKenna, PT, DPT
• Isabella McLaughlin

• Physician Assistant in Galloway, NJ
• Providers in Galloway, 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 May 21, 2025; 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.