Emily McCullen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601009610 Issued in MI

Practice address

29531 Plymouth Rd
Livonia, MI 48150-2125

Phone

(734) 525-7939

Fax

(313) 876-1305

NPI assigned

Nov 14, 2018

Last updated

Nov 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 MI

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Urgent CareGroup PAC ID 6901296110, 111 clinicians

Promed Preferred Mi 2 PLLCGroup PAC ID 0345779369, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: emccullen818317@direct.hfhs.org
• Direct secure messaging: emily.mccullen.1@30652.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry Ford Urgent Care

  dba Henry Ford GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Detroit, MI
  • NPI 1184389876
  Medicare reassignment Care Compare group
• Advanced Wound Care Specialists PC

  • Internal Medicine Physician
  • Caro, MI
  • NPI 1932082203

  Physician Assistant

  Medicare reassignment NPD
• Advanced Wound Care of Caro PC

  • Internal Medicine Physician
  • Caro, MI
  • NPI 1700666708
  Medicare reassignment
• Promed Preferred Mi 2, PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1245049311
  NPD
• Henry Ford Maplegrove Center

  dba Henry Ford Health System

  • Children's Substance Abuse Rehabilitation Facility
  • West Bloomfield, MI
  • NPI 1295767630
  NPD (past)

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1891264388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806",
            "fax_number": "313-876-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29531 PLYMOUTH RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502125",
            "telephone_number": "734-525-7939",
            "fax_number": "313-876-1305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7125 Orchard Lake Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483223616",
            "country_code": "US",
            "telephone_number": "248-865-7481 x25",
            "fax_number": "248-847-3135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCULLEN",
        "first_name": "EMILY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-14",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601009610",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle McCoy
• Madison McCracken
• Tammy McCrory, LLP BCBA
• Krystle Lynn McCubbin
• Megan Elizabeth McCuen
• Elizabeth Lane McCullough, MD
• Rebecca McCullough
• Asia McCurdy Knott
• Markita McCutchen, LPC
• Danielle McDonald

• Physician Assistant in Livonia, MI
• Providers in Livonia, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.