Individual provider Active NPI

Marylouise Cullinan, MD

  • Infectious Disease Physician
  • Thornton, CO
National Provider Identifier
1710041942
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
25375 Issued in CO
Practice address
9141 Grant St
Suite 125
Thornton, CO 80229-4374
Phone
(303) 522-4686
Fax
(303) 980-0431
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 25375 CO Primary

Addresses

Primary practice location

9141 Grant St
Suite 125
Thornton, CO 80229-4374

Mailing address

9141 Grant St
Suite 125
Thornton, CO 80229-4374
Phone (303) 522-4686

Other identifiers 1

IdentifierTypeStateIssuer
01253756MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051104000472 CO Practitioner - Infectious Disease 9335166800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Saint Louis University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9141 Grant St
Suite 125
Thornton, CO 80229-4367
Phone (303) 522-4686

Hospital & facility affiliations

  • HCA Healthone Mountain Ridge Hospital, Thornton, CO, CCN 060065
  • Centura Health-St Anthony Hospital Hospital, Lakewood, CO, CCN 060015
  • AdventHealth Porter Hospital, Denver, CO, CCN 060064

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue119
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Metro Infectious Disease Specialists, P.C. Infectious Disease CurrentSince Jun 19, 2005 Accepting new patients
Western Infectious Disease Consultants, P.C. Infectious Disease Past Accepting new patients
Western Infectious Disease Infusion Center, Inc Infectious Disease Past Accepting new patients

Locations

9141 Grant St
Ste 125
Thornton, CO 80229
Phone (303) 453-2460

Organizations & group practices 3

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1710041942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9141 GRANT ST",
            "address_2": "SUITE 125",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294374",
            "telephone_number": "303-522-4686",
            "fax_number": "303-980-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9141 GRANT ST",
            "address_2": "SUITE 125",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294374",
            "telephone_number": "303-522-4686",
            "fax_number": "303-980-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLINAN",
        "first_name": "MARYLOUISE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CO",
            "license": "25375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01253756",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.