Melissa J McCulley, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ND597 Issued in ND

Practice address

2553 Kirsten LN S # 202
Fargo, ND 58104-4901

Phone

(701) 373-2020

Fax

(701) 373-0021

NPI assigned

Mar 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Melissa J McCulley O D P C

  • Optometrist
  • West Fargo, ND
  • NPI 1497871214
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912023714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2553 KIRSTEN LN S # 202",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044901",
            "telephone_number": "701-373-2020",
            "fax_number": "701-373-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2553 KIRSTEN LN S # 202",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044901",
            "telephone_number": "701-373-2020",
            "fax_number": "701-373-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLEY",
        "first_name": "MELISSA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "ND597",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2824",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "88G84MC",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "026373",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Michael McConnon
• Elizabeth Debra McCormack, ATC
• Kelly Jeanne McCormick, LAC
• Samson McCoy
• Marcy Brooke McCue, BSN, RN
• Sarah J. McCullough, M.D.
• Jon'E Kaye McDaniel
• Savannah Marie McDaniel, LMT
• McDonald & Gruchalla, D.D.S., P.C.
• Elizabeth McDonald

• Optometrist in Fargo, ND
• Providers in Fargo, ND by specialty
• Optometrist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.