Amy Ruth Cullen, M.D., M.A.
Individual provider Active NPI Family Medicine Physician · Laguna Woods, CA
NPI 1992865281 · NPPES record last updated Aug 28, 2020
Key facts
- NPI
- 1992865281
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A80157 (CA)
- Practice address
- 484 Calle Cadiz Unit B
Laguna Woods, CA 92637-8925 - Phone
- (949) 887-1017
- NPI assigned
- Dec 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 1
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
13950 Milton Ave
Suite 400B
Westminster, CA 92683-2939
Phone (888) 959-9280
Hospital & facility affiliations
- Compassionate Care Hospice, LLC
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 28 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Compassionate Care Hospice, LLC |
Hospice | Operational/Managerial Control (100%) | Apr 24, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170313001540 | CA | Practitioner - Family Practice | 0143362186 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A80157 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Housecall Doctors Medical Group Inc | Current |
Accepting new patients | |
| Wound Solutions of California | Current |
Accepting new patients |
Locations
23181 Verdugo Dr
Ste 103A
Laguna Hills, CA 92653
Phone (800) 964-4364
3800 Kilroy Airport Way
Ste 270
Long Beach, CA 90806
Phone (949) 366-1053
13950 Milton Ave
Ste 400B
Westminster, CA 92683
Phone (888) 959-9280
Interoperability endpoints
- amy.cullen.1@33925.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A80157 | CA | Yes |
Addresses
Primary practice location
484 Calle Cadiz Unit B
Laguna Woods, CA 92637-8925
Mailing address
484 Calle Cadiz B
Laguna Woods, CA 92637-8925
Phone (949) 887-1017
Other practice location 1
3210 Idaho Pl
Costa Mesa, CA 92626-2208
Phone (714) 241-7283
Other providers in Laguna Woods, CA
- Kyle Wayne Coker
- Kent J Collins
- Cox Dental Corporation
- Lydia Creedon
- Csun Pharmaceutics Inc
- Peter Vincent Phillip Dangvu
- Alexandria Eve Dao
- Ferial Darbani
- Lyndsay T Defilippo
- Ali Dehbozorgi
All providers in Laguna Woods, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.