Individual provider Active NPI

Michael McCullough

  • Vascular & Interventional Radiology Physician
  • Washington, DC
National Provider Identifier
1902878903
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
35366 Issued in DC
Practice address
3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone
(202) 444-5748
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 35366 DC Primary

Addresses

Primary practice location

3800 Reservoir Rd NW
Washington, DC 20007-2113

Mailing address

PO Box 631856
Baltimore, MD 21263-1856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, MD3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20040216001021 DC Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 9830084276 Reassigns benefits to 2 organizations
I20070809000756 VA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 9830084276 Reassigns benefits to 2 organizations
I20240826000110 MD Practitioner - Diagnostic Radiology 9830084276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Georgetown University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone (202) 444-2000

Hospital & facility affiliations

  • Medstar Georgetown University Hospital Hospital, Washington, DC, CCN 090004

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35366DCMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group Radiology, LLC Vascular & Interventional Radiology CurrentSince Jul 1, 2016 Accepting new patients
Medstar Medical Group II LLC CurrentSince Oct 1, 2024 Accepting new patients
Association of Alexandria Radiologists, P.C. Vascular & Interventional Radiology PastSince Aug 1, 2005 Accepting new patients
Magnetic Resonance Imaging Associates of VA, PC Vascular & Interventional Radiology Past Accepting new patients
Computed Tomography Associates, PC Vascular & Interventional Radiology Past Accepting new patients
Medstar Medical Group Radiology, LLC PastSince Feb 14, 2021 Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients
Medstar Georgetown Medical Center Past Accepting new patients

Locations

110 Irving St NW
Rm BA94
Washington, DC 20010
Phone (202) 877-6429

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

2331 Broadbirch Dr
Silver Spring, MD 20904
Phone (301) 652-5771

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

Organizations & group practices 8

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 1

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1902878903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631856",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212631856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072113",
            "telephone_number": "202-444-5748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "DC",
            "license": "35366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.