Individual provider Active NPI

Paul McCullough, M.D.

  • Anesthesiology Physician
  • St George, UT
National Provider Identifier
1932321346
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
12078813-1205 Issued in UT
Practice address
1380 E Medical Center Dr
St George, UT 84790-2123
Phone
(801) 727-2056
Fax
(770) 701-6675
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD153282 OR
Anesthesiology Physician 207L00000X MT188120 PA
Anesthesiology Physician 207L00000X 12078813-1205 UT Primary

Addresses

Primary practice location

1380 E Medical Center Dr
St George, UT 84790-2123

Mailing address

PO Box 3570
Salt Lake City, UT 84110-3570
Phone (801) 727-2056

Other practice location 1

3600 NW Samaritan Dr
Corvallis, OR 97330-5472
Phone (541) 768-5111

Other identifiers 1

IdentifierTypeStateIssuer
500636545MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pmccullough268396@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, UT2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20110805000383 OR Practitioner - Anesthesiology 1355510439 Reassigns benefits to 1 organization
I20210209001003 UT Practitioner - Anesthesiology 1355510439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Saint Louis University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain West Anesthesia LLCGroup PAC ID 9032018502, 267 clinicians

Practice addresses (Care Compare)

544 S 400
St George, UT 84770-3705
Phone (435) 674-5230

Hospital & facility affiliations

  • St. George Regional Hospital Hospital, St George, UT, CCN 460021
  • Salem Hospital Hospital, Salem, OR, CCN 380051

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as group
Quality
85.78
Promoting interoperability
100
Improvement activities
40
Cost
78.31

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
89.3
Improvement activities
40
Cost
78.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT188120PAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Anesthesiology Group PC Anesthesiology CurrentSince Jul 5, 2011 Accepting new patients
Mountain West Anesthesia LLC Anesthesiology CurrentSince Feb 1, 2021 Accepting new patients
Oag Trauma Services LLC Anesthesiology PastSince Jul 5, 2011 Accepting new patients
Corvallis Radiology PC Past Accepting new patients

Locations

633 Waverly Dr SE
Albany, OR 97322
Phone (541) 286-2309

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

3600 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 768-4906

707 SW Washington St
Ste 700
Portland, OR 97205

1445 State St
Salem, OR 97301
Phone (503) 315-7338

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

890 Oak St SE
Salem, OR 97301
Phone (503) 585-0830

3340 N Center St
Ste 800
Lehi, UT 84043
Phone (800) 501-4788

150 W Civic Center Dr
Ste 200
Sandy, UT 84070
Phone (801) 727-2056

544 S 400 E
St George, UT 84770
Phone (435) 688-4000

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

Interoperability endpoints

  • Direct secure messaging: pmccullough268396@samhealth.direct-ci.com

Organizations & group practices 4

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 2

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1932321346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3570",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103570",
            "telephone_number": "801-727-2056",
            "fax_number": "770-701-6675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 E MEDICAL CENTER DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847902123",
            "telephone_number": "801-727-2056",
            "fax_number": "770-701-6675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 NW Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973305472",
            "country_code": "US",
            "telephone_number": "541-768-5111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD153282",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MT188120",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "12078813-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500636545",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmccullough268396@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3600 NW Samaritan Dr",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973305472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.