Active NPI
Deborah M. Tong, P.A.
- Physician Assistant
- Wheat Ridge, CO
National Provider Identifier
1992846331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA.0001454
- Practice address
- 7495 W 29TH Ave
Wheat Ridge, CO 80033-8002 - Phone
- (303) 239-9964
- Fax
- (303) 237-4343
- NPI assigned
- Feb 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA.0001454 | CO | Primary |
Addresses
Primary practice location
7495 W 29TH Ave
Wheat Ridge, CO 80033-8002
Mailing address
3701 S Broadway
Englewood, CO 80113-3611
Phone (303) 761-1977
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19671334 | Medicaid | CO |
Other names 1
- Deborah M. McCullough
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150303001818 | CO | Order and Referring Only - Physician Assistant | 1456677707 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA.0001454 | CO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509926400000",
"number": "1992846331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3701 S BROADWAY",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801133611",
"telephone_number": "303-761-1977",
"fax_number": "303-761-2787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7495 W 29TH AVE",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "800338002",
"telephone_number": "303-239-9964",
"fax_number": "303-237-4343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TONG",
"first_name": "DEBORAH",
"middle_name": "M.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-09",
"last_updated": "2017-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "PA.0001454",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "19671334",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DEBORAH",
"last_name": "MCCULLOUGH",
"middle_name": "M.",
"credential": "P.A.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Wheat Ridge, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.