Individual provider Active NPI

Erwin Kurt Tan Cullamar, MD

  • Hospitalist Physician
  • Dover, NH
National Provider Identifier
1982605200
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
12371 Issued in NH
Practice address
789 Central Ave
Level 2
Dover, NH 03820-2526
Phone
(603) 740-2503
Fax
(603) 740-2497
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12371 NH
Hospitalist Physician 208M00000X 12371 NH Primary

Addresses

Primary practice location

789 Central Ave
Level 2
Dover, NH 03820-2526

Mailing address

789 Central Ave
Dover, NH 03820-2526
Phone (603) 740-2503

Other identifiers 3

IdentifierTypeStateIssuer
1982605200MedicaidME
3074776MedicaidNH
P00706658OtherNHRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20041019000805 NH Practitioner - Hospitalist 1759342280 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wentworth Douglass Physician CorporationGroup PAC ID 5496749848, 429 clinicians

Practice addresses (Care Compare)

789 Central Ave
Dover, NH 03820-2526
Phone (603) 740-4478

Hospital & facility affiliations

  • Wentworth-Douglass Hospital Hospital, Dover, NH, CCN 300018
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12371NHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Littleton Hospital Association CurrentSince Jun 8, 2015 Accepting new patients
Wentworth Douglass Hospital Current Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Dec 15, 2008 Accepting new patients
Littleton Hospital Association CurrentSince Jun 8, 2015 Accepting new patients
Wentworth Douglass Physician Corporation Hospitalist CurrentSince Dec 15, 2008 Accepting new patients
Westchester Neurological Consultant PC Past Accepting new patients
Wentworth Douglass Hospital Past Accepting new patients

Locations

789 Central Ave
#2
Dover, NH 03820
Phone (603) 740-2503

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

750 Central Ave
Ste Q
Dover, NH 03820
Phone (603) 742-6030

600 Saint Johnsbury Rd
Littleton, NH 03561
Phone (603) 444-9000

2936 White Mountain Hwy
#1
North Conway, NH 03860
Phone (603) 823-8600

Interoperability endpoints

  • Direct secure messaging: cullamar.erwin.wdh@direct.partners.masshiway.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 7

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 3

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1982605200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-740-2503",
            "fax_number": "603-740-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "address_2": "LEVEL 2",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-740-2503",
            "fax_number": "603-740-2497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLAMAR",
        "first_name": "ERWIN KURT",
        "middle_name": "TAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "12371",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NH",
            "license": "12371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982605200",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3074776",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00706658",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.