Mary Polleys Mcculloch, NNP - Medicare Nurse Practitioner in Boise, ID

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Mary Polleys Mcculloch, NNP is a medicare enrolled "Nurse Practitioner - Neonatal, Critical Care" in Boise, Idaho. She graduated from nursing school in 1982 and has 44 years of diverse experience with area of expertise as Nurse Practitioner. Her current practice location is 190 E Bannock St, Boise, Idaho. You can reach out to her office (for appointments etc.) via phone at (208) 381-2088.

Mary Polleys Mcculloch is licensed to practice in Idaho (license number 58268) and she also participates in the medicare program. She may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1275672396.

Contact Information

Mary Polleys Mcculloch, NNP
190 E Bannock St,
Boise, ID 83712-6241
(208) 381-2088
Not Available

Map and Direction




Provider's Profile

Full NameMary Polleys Mcculloch
GenderFemale
SpecialityNurse Practitioner
Experience44 Years
Location190 E Bannock St, Boise, Idaho
Accepts Medicare AssignmentsMay be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mary Polleys Mcculloch graduated from nursing school in 1982
  NPI Data:
  • NPI Number: 1275672396
  • Provider Enumeration Date: 02/05/2007
  • Last Update Date: 04/27/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 2466837745
  • Enrollment ID: I20251216002724

Medical Identifiers

Medical identifiers for Mary Polleys Mcculloch such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275672396NPI-NPPES
176667MedicaidAZ

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LN0005XNurse Practitioner - Neonatal, Critical Care 289606 (Arizona)Secondary
363LN0005XNurse Practitioner - Neonatal, Critical Care 2203014405 (Utah)Secondary
363LN0005XNurse Practitioner - Neonatal, Critical Care 58268 (Idaho)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. Mary Polleys Mcculloch allows following entities to bill medicare on her behalf.
Entity NameTucson Physician Group Holdings LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1356726939
PECOS PAC ID: 0547560070
Enrollment ID: O20151204001261

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. Mary Polleys Mcculloch 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 AddressPractice Location Address
Mary Polleys Mcculloch, NNP
190 E Bannock St,
Boise, ID 83712-6241

Ph: Not Available		Mary Polleys Mcculloch, NNP
190 E Bannock St,
Boise, ID 83712-6241

Ph: (208) 381-2088

Reviews and Comments


Nurse Practitioner Nurses in Boise, ID

Nora M Suarez, NP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 190 E Bannock St, Boise, ID 83712
Phone: 208-381-2222    
Elizabeth Hingley, NP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 460 W Sandstone Ct, Boise, ID 83702
Phone: 662-889-0513    Fax: 863-228-8587
Dr. Nancy Jane L'heureux, DNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 2273 S Vista Ave Ste 190, Boise, ID 83705
Phone: 208-343-2737    Fax: 208-342-3238
Jennifer Woodburn,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 190 E Bannock St, Boise, ID 83712
Phone: 208-381-5015    
Carl Ciplinski, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 10583 W Lake Hazel Rd, Boise, ID 83709
Phone: 208-302-5950    
Kathryn Laura Cnossen, NP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 8000 S Federal Way, Boise, ID 83716
Phone: 208-368-2109    
Mrs. Chelsea Rose Wallace, RN, FNP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 9976 W Emerald St, Boise, ID 83704
Phone: 208-229-3742    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.