DR. TIMOTHY JOHN MCCULLOUGH (NPI# 1841345725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841345725 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY JOHN MCCULLOUGH |
| Credential | M.D. |
| Practice Address |
1415 Portland Ave Rochester NY 14621-3038 |
| Mailing Address |
9310 Greenheather Dr Huntersville NC 28078-3279 |
| Practice Telephone | 5853420140 |
| Practice Fax Number | 5853365113 |
| Mailing Telephone | 7049925610 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 149086 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00988243 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275548927 | Timothy Mccullough | Physical Therapist | 11 Pleasant St., Smart Physical Therapy LLC, New London, NH 03257-5834 | 2006-07-30 |
| 1457727893 | Timothy Mccullough | Physician Assistant | 2400 Patterson St Ste 307, Nashville, TN 37203 | 2015-08-20 |
| 1881808947 | Timothy Casey Mccullough | Urology | 10730 Medlock Bridge Rd Ste 110, Johns Creek, GA 30097 | 2007-05-09 |
| 1093852428 | Timothy C. Mccullough | Chiropractor | 11003 Resource Pkwy, Suite 103, Houston, TX 77089-6141 | 2007-02-01 |
| 1275528184 | Timothy Mccullough | Emergency Medicine | 1000 E Cherry St, Troy, MO 63379-1513 | 2005-09-16 |
| Street Address |
1415 PORTLAND AVE |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14621-3038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902808223 | Scott L Schabel | Internal Medicine | 1415 Portland Ave, Suite 200, Rochester, NY 14621-3038 | 2005-06-01 |
| 1063055507 | Denetra Morris | Social Worker | 1415 Portland Ave, Rochester, NY 14621-3038 | 2019-10-28 |
| 1518423052 | Jillian Elizabeth Foster | Physician Assistant | 1415 Portland Ave, Rochester, NY 14621-3038 | 2019-02-20 |
| 1184109084 | Melissa Podkulski | Physician Assistant | 1415 Portland Ave, Rochester, NY 14621-3038 | 2018-09-27 |
| 1689129686 | Claire Helene Smith | Physician Assistant | 1415 Portland Ave, Rochester, NY 14621-3038 | 2016-08-19 |
| 1255885281 | Rachel Houghtling | Physician Assistant | 1415 Portland Ave, Rochester, NY 14621-3038 | 2016-08-08 |
| 1467812214 | Laura Koenig | Nurse Practitioner | 1415 Portland Ave, Rochester, NY 14621-3038 | 2016-03-07 |
| 1972972016 | Lauren Eva Hall | Physician Assistant | 1415 Portland Ave, Suite 350, Rochester, NY 14621-3043 | 2015-09-18 |
| 1457758377 | Kristin Rose Henchenski | Physician Assistant | 1415 Portland Ave, Suite 225, Rochester, NY 14621-3039 | 2014-11-20 |
| 1083011076 | Larissa Chapkovich | Dietitian, Registered | 1415 Portland Ave, Rochester, NY 14621-3038 | 2014-11-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619515327 | Patti Humphrey | Occupational Therapist | 1831 Ridge Rd. East, Rochester, NY 14621 | 2019-12-12 |
| 1861956682 | Sonya Thomas | Counselor | Sonya Thomas, 490 East Ridge Road, Rochester, NY 14621 | 2019-01-25 |
| 1811478357 | Laura Iannella | Student in an Organized Health Care Education/Training Program | 1455 East Ridge, Rochester, NY 14621 | 2018-08-23 |
| 1982180345 | Naman Sharma | Student in an Organized Health Care Education/Training Program | Rochester General Hospital, 1425 Portland Avenue, Rochester, NY 14621 | 2018-07-18 |
| 1699213447 | Kara Mcallister | Nurse Practitioner | 370 East Ridge Road, Suite 400, Rochester, NY 14621 | 2017-02-01 |
| 1285082982 | Universal Care Services, LLC | In Home Supportive Care | 64 Delamaine Drive, Rochester, NY 14621 | 2016-06-03 |
| 1700243896 | Kenroy King I | Registered Nurse | 67 Warsaw Street, Rochester, NY 14621 | 2016-01-21 |
| 1154794808 | Shari Venisee | Licensed Practical Nurse | 67 Carthage St, Rochester, NY 14621 | 2015-11-03 |
| 1114349024 | Anthony Michael Plavsity | Registered Nurse | 1450 Clifford Ave, Rochester, NY 14621 | 2014-01-11 |
| 1033541107 | The Community Place of Greater Rochester, Inc | Case Management | 500 Carter Street, Rochester, NY 14621 | 2013-07-31 |
| Find all providers in zip 14621 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518512680 | Loay Aljaberi | Surgery | Mayo Clinic 200 1st Sw, Rochester, MN 55905-0001 | 2019-08-06 |
| 1669836268 | Erinn Afflick | Surgery | 200 1st South St, Rochester, MN 55905-0001 | 2016-04-09 |
| 1134567944 | Brent Paul Miller | Surgery | 99 Canal Landing Blvd Ste 6, Rochester, NY 14626-5112 | 2013-06-13 |
| 1235428855 | Mohamed Fadhl Algahim | Surgery | 601 Elmwood Ave Box Surg/cardiac, Rochester, NY 14642-3548 | 2011-04-04 |
| 1366680720 | Megan H. Nelson | Surgery | 200 First Street S.w., Rochester, MN 55905 | 2009-01-23 |
| 1396994109 | Celso E Dias | Surgery | 30 Hagen Dr Suite 120, Rochester, NY 14625 | 2008-09-17 |
| 1427225317 | Bala Gangadhara Reddy Thatigotla | Surgery | 1415 Portland Ave Ste 225, Rochester, NY 14621-3039 | 2008-05-11 |
| 1184824294 | Alok D Gandhi | Surgery | 1415portland Ave, Suite 225, Rochester, NY 14621-3001 | 2007-07-18 |
| 1790896330 | Mehdi Shemirani | Surgery | 1360 Portland Avenue, Suite 202, Rochester, NY 14621-3002 | 2006-08-31 |
| 1386662591 | Vincent Chang | Surgery | 1299 Portland Ave Ste 3, Rochester, NY 14621-2727 | 2006-07-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.