Jackie Mccullough, MOTR/L is a medicare enrolled "Occupational Therapist" provider in Brownstown, Michigan. Her current practice location is
19135 Holdren St, Brownstown, Michigan. You can reach out to her office (for appointments etc.) via phone at
(313) 999-0873.
Jackie Mccullough is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1841781606.
Healthcare Provider's Profile
| Full Name | Jackie Mccullough |
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| Gender | Female |
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| Speciality | Occupational Therapist |
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| Location | 19135 Holdren St, Brownstown, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1841781606
- Provider Enumeration Date: 05/28/2018
- Last Update Date: 05/28/2018
Medicare PECOS Information:
- PECOS PAC ID: 1153705082
- Enrollment ID: I20220826000928
Medical Identifiers
Medical identifiers for Jackie Mccullough such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1841781606 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225X00000X | Occupational Therapist | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jackie Mccullough allows following entities to bill medicare on her behalf.
| Provider Name | Therapy Management Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1407293640
PECOS PAC ID: 2961630645
Enrollment ID: O20140103000154 |
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| Provider Name | Tmi East Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1336709252
PECOS PAC ID: 3274864665
Enrollment ID: O20200420003011 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jackie Mccullough is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Jackie Mccullough, MOTR/L
28349 Joy Rd,
Westland, MI 48185-5524
Ph: () - | Jackie Mccullough, MOTR/L
19135 Holdren St,
Brownstown, MI 48173-9307
Ph: (313) 999-0873 |
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