CULLEN RICHARD SHANROCK DPM - NPI 1083298673

Q: What is the provider's specialty?

The provider's specialty is Podiatrist with taxonomy code 213ES0103X and a focus in Foot & Ankle Surgery.

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About Cullen Richard Shanrock Dpm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CULLEN RICHARD SHANROCK DPM (NPI 1083298673) is an individual foot & ankle surgery provider in Woodruff, Wisconsin, licensed in Wisconsin (1339-25) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS and is a graduate of New York College Of Podiatric Medicine (2021).

NPPES Registry Identity

NPI1083298673

Entity TypeIndividualMale

Primary Taxonomy213ES0103X

Provider Legal NameCULLEN RICHARD SHANROCKCredential: DPM

Location Address311 ELM STWoodruff, WI 54568-9149

Mailing Address7428 Loon Landing ShrsLake Tomahawk, WI 54539-9110 · (651) 564-2094

Phone(651) 564-2094

Sole ProprietorYes

Medical School CMSNew York College Of Podiatric MedicineGraduated 2021

Enumeration DateMay 10, 2021

Last NPPES UpdateOctober 1, 20242 updates tracked since enumeration

NPPES CertifiedOctober 1, 2024

✔ NPI 1083298673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers

Taxonomy Code213ES0103X

License✔ Licensed in WI · 1339-25

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

311 ELM ST, Woodruff, WI 54568

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, HealthPartners and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Cullen Richard Shanrock Dpm is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8022543735

PECOS Enrollment IDI20241118004150, I20241120000560

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.