Connor Mccullough, in Columbus, WI - Medicare Physical Therapist Provider

Connor Mccullough, is a medicare enrolled "Physical Therapist" provider in Columbus, Wisconsin. His current practice location is 1515 Park Ave, Columbus, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 623-2200.

Connor Mccullough is licensed to practice in Wisconsin (license number 16816-24) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1346082021.

Contact Information

	Connor Mccullough,
	1515 Park Ave, Columbus, WI 53925-2402
	(920) 623-2200
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Connor Mccullough
Gender	Male
Speciality	Physical Therapist
Location	1515 Park Ave, Columbus, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1346082021
Provider Enumeration Date: 06/12/2024
Last Update Date: 06/12/2024

Medicare PECOS Information:

PECOS PAC ID: 7719427053
Enrollment ID: I20240912002934

Medical Identifiers

Medical identifiers for Connor Mccullough such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1346082021	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	16816-24 (Wisconsin)	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. Connor Mccullough allows following entities to bill medicare on his behalf.

Provider Name	Prairie Ridge Health Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1154403657 PECOS PAC ID: 6800791484 Enrollment ID: O20040210000777

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. Connor 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
Connor Mccullough, 1515 Park Ave, Columbus, WI 53925-2402 Ph: (920) 623-2200	Connor Mccullough, 1515 Park Ave, Columbus, WI 53925-2402 Ph: (920) 623-2200

Reviews and Comments

Physical Therapist in Columbus, WI

Lori Lawrence, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1515 Park Ave, Columbus, WI 53925 Phone: 920-623-1430
Sydney Mikulas, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1515 Park Ave, Columbus, WI 53925 Phone: 920-623-2200
Kayla Sharpee, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1515 Park Ave, Columbus, WI 53925 Phone: 920-623-2200
Brianne Trevorrow, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1515 Park Ave, Columbus, WI 53925 Phone: 920-623-2200
Mrs. Lynn M. Lenling, PHYSICAL THERAPIST Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 825 Western Ave, Columbus, WI 53925 Phone: 920-623-2520
Stacey Depies, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1515 Park Ave, Columbus, WI 53925 Phone: 920-623-2200

Connor Mccullough, - Medicare Physical Therapist in Columbus, WI