Sophia Grecos McCullough, MD
Individual provider Active NPI Pediatrics Physician · Waterville, OH
NPI 1790788966 · NPPES record last updated Jan 23, 2026
Key facts
- NPI
- 1790788966
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 35083028 (OH)
- Practice address
- 1089 Pray Blvd
Waterville, OH 43566-8712 - Phone
- (567) 952-2100
- Fax
- (567) 952-2010
- NPI assigned
- May 23, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.34 of 100
- Quality
- 69.17
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 75
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161128001987 | OH | Practitioner - Pediatric Medicine | 6305125873 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35083028 | OH | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical University of Ohio at Toledo | Current | Accepting new patients | |
| University of Toledo Physicians LLC | Pediatrics | Current |
Accepting new patients |
Locations
L4189
Columbus, OH 43260
3125 Transverse Dr
Ste C
Toledo, OH 43614
Phone (419) 383-3771
3125 Transverse Dr
Toledo, OH 43614
Phone (419) 383-3771
3000 Arlington Ave
Stop 1108
Toledo, OH 43614
3355 Glendale Ave
Toledo, OH 43614
Phone (419) 383-5614
3355 Glendale Ave
Fl 3
Toledo, OH 43614
Phone (419) 383-7100
1000 Regency Ct
Ste 200
Toledo, OH 43623
Phone (419) 383-2450
1089 Pray Blvd
Waterville, OH 43566
Phone (419) 383-8500
Interoperability endpoints
- smccullough25421@direct.utoledo.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35083028 | OH | Yes |
Addresses
Primary practice location
1089 Pray Blvd
Waterville, OH 43566-8712
Mailing address
3000 Arlington Ave Stop 1108
Toledo, OH 43614-2595
Phone (419) 383-5322
Other practice location 1
3125 Transverse Dr Ste C
Toledo, OH 43614-8008
Phone (419) 383-3771
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0192437 | Medicaid | OH | |
| 029078500 | Medicaid | MD |
Other providers in Waterville, OH
- Ronald S. Lukasik II
- Kenan Maaieh
- Marie L Martin
- Peggy Sue Matailo
- Esther Njeri Mburu
- Medical University of Ohio at Toledo
- Clark Melvin
- Sarah Mackesy Miller
- Moonflower Therapy Services LLC
- Brandon Moore
All providers in Waterville, OH · Pediatrics Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.