DR. EDWARD THOMAS CULLEN MD
NPI 1083775126
Internal Medicine in Oxon Hill, MD

NPI Status: Active since December 13, 2006

Contact Information

6188 OXON HILL ROAD
SUITE 704
OXON HILL, MD
ZIP 20745
Phone: (301) 839-2790
Fax: (301) 839-3042

Get Directions Reviews

  • Individual
  • Male
  • Years of Experience 46
  • Internal Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment
  • Medicare Quality Reporting

About EDWARD CULLEN

Edward Cullen is an internist established in Oxon Hill, Maryland and his medical specialization is Internal Medicine with more than 46 years of experience. He graduated from Georgetown University School Of Medicine in 1978. The healthcare provider is registered in the NPI registry with number 1083775126 assigned on December 2006. The practitioner's primary taxonomy code is 207R00000X with license number D0026607 (MD). The provider is registered as an individual and his NPI record was last updated 16 years ago.

NPI
1083775126
Provider Name
DR. EDWARD THOMAS CULLEN MD
Gender
Male
Entity Type
Individual
Location Address
6188 OXON HILL ROAD SUITE 704 OXON HILL, MD 20745
Location Phone
(301) 839-2790
Location Fax
(301) 839-3042
Mailing Address
6188 OXON HILL ROAD SUITE 704 OXON HILL, MD 20745
Mailing Phone
(301) 839-2790
Mailing Fax
(301) 839-3042
Medical School Name
GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
1978
Is Sole Proprietor?
No
Enumeration Date
12-13-2006
Last Update Date
03-04-2008
Code Navigator

An internist like Edward Cullen is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Edward Cullen is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program and the following quality measures were reported: e-prescribing, implementation of medication management practice improvements, measurement and improvement at the practice and panel level, medication reconciliation, patient-specific education, provide patient access, secure messaging, security risk analysis and specialized registry reporting. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries.

The typical physician office visit costs for Medicare beneficiaries in this area are: $38.79 for a new patient copayment and $30.05 for an established patient copayment.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
D0026607
License State
MD
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

MD13637 (DC)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Medicare

  • Medicaid

  • Blue Cross Blue Shield

  • Aetna


*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
144561OTHER (01)UNITED HEALTH CARE
0202OTHER (01)BCBS NATL CAPITOL AREA
D05903MEDICARE UPIN (02) 
G00106MEDICARE PIN (08)MD 
4086948OTHER (01)AETNA
41238504OTHER (01)BCBS OF MARYLAND

PECOS Enrollment and Medicare Participation Status

Edward Cullen is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 840330874

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20110415000034

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • Other DME (D1E)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    8 DME suppliers used 19 Medicare Claims 52 Services Paid

  • Other DME (D1E)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    5 DME suppliers used 15 Medicare Claims 76 Services Paid

  • Hospital beds (D1B)

    Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

    1 DME suppliers used 11 Medicare Claims 11 Services Paid

  • Other DME (D1E)

    Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

    2 DME suppliers used 22 Medicare Claims 22 Services Paid

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 20745 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $155.19
  • Minimum New Patient Price $68.56
  • Maximum New Patient Price $204.56
  • Average New Patient Copayment $38.79
  • Minimum New Patient Copayment $17.14
  • Maximum New Patient Copayment $51.14

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $120.2
  • Minimum Established Patient Price $21.87
  • Maximum Established Patient Price $167.24
  • Average Established Patient Copayment $30.05
  • Minimum Established Patient Copayment $5.46
  • Maximum Established Patient Copayment $41.81

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
e-Prescribing 89% 180
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Medication Reconciliation 97% 187
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education 69% 1098
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Provide Patient Access 100% 1088
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging 65% 1088
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 387

    Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)

  • 348

    Urinalysis, manual test (HCPCS:81002)

  • 193

    Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)

  • 168

    Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)

  • 152

    Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

  • 92

    Measurement and graphic recording of total and timed exhaled air capacity (HCPCS:94010)

  • 68

    Removal of impact ear wax, one ear (HCPCS:69210)

  • 49

    Administration of influenza virus vaccine (HCPCS:G0008)

  • 35

    Administration of pneumococcal vaccine (HCPCS:G0009)

  • 20

    Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)

  • 14

    Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration (HCPCS:94060)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Edward Cullen is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
SIBLEY MEMORIAL HOSPITAL5255 LOUGHBORO RD NW
WASHINGTON, DC 20016
(202) 537-4680Acute Care Hospitals

Reviews for DR. EDWARD THOMAS CULLEN MD

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1083775126
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
201631471014
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 1 + 6 + 3 + 1 + 4 + 7 + 1 + 0 + 1 + 4 + 24 = 54
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 54 = 66

The NPI number 1083775126 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 10 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1033215371DR. UCHECHI T OPAIGBEOGU M.D.
Individual
Family Medicine6188 OXON HILL ROAD SUITE 701
OXON HILL, MD 20745
(301) 686-0067
1104988054DR. DENNIS ALOYSIUS CULLEN MD
Individual
Internal Medicine6188 OXON HILL ROAD SUITE 704
OXON HILL, MD 20745
(301) 839-2790
1952466971CULLEN UMOSELLA CULLEN & CULLEN PC
Organization
Internal Medicine6188 OXON HILL ROAD SUITE 704
OXON HILL, MD 20745
(301) 839-2790
1578983896FAMILY DENTAL CARE CENTER
Organization
Durable Medical Equipment & Medical Supplies6188 OXON HILL ROAD SUITE 406
OXON HILL, MD 20745
(301) 839-6330
1184188500MR. GARY ALEXANDER HORSEY M.A.
Individual
Counselor (Professional)6188 OXON HILL ROAD SUITE 500
OXON HILL, MD 20745
(301) 567-0400
1841754140MS. GLENDA LAURENT DICKONSON PH.D., LCPC
Individual
Counselor (Professional)6188 OXON HILL ROAD SUITE 500
OXON HILL, MD 20745
(301) 567-0400
1760946065MRS. MIKHAIL KIANA PIPER LGPC
Individual
Counselor (Professional)6188 OXON HILL ROAD SUITE 500
OXON HILL, MD 20745
(301) 567-0400
1417413147MRS. NIKEITA GRADY LAWRENCE LMSW
Individual
Social Worker (Clinical)6188 OXON HILL ROAD SUITE 500
OXON HILL, MD 20745
(301) 567-0400
1316403041MS. MYRA O'BRIEN MOORE
Individual
Social Worker (Clinical)6188 OXON HILL ROAD SUITE 500
OXON HILL, MD 20745
(301) 567-0400
1013471317MRS. SHARON J. CHURCH LCPC
Individual
Counselor (Professional)6188 OXON HILL ROAD SUITE 500
OXON HILL, MD 20745
(301) 567-0400

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083775126, enumerated in the NPI registry as an "individual" on December 13, 2006

The provider is located at 6188 Oxon Hill Road Suite 704 Oxon Hill, Md 20745 and the phone number is (301) 839-2790

The provider's speciality is Internal Medicine with taxonomy code 207R00000X

The provider has more than 46 years of experience. He graduated from Georgetown University School Of Medicine in 1978.

The provider might be accepting Accepts: Medicare, Medicaid, Blue Cross Blue Shield and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of May 17, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $155.19 with an average copayment of $38.79 for new patient appointments. Established patients should expect a typical charge of $120.2 and an average copayment of 30.05. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Routine ekg using at least 12 leads including interpretation and report, Urinalysis, manual test, Injection beneath the skin or into muscle for therapy, diagnosis, or prevention, Injection, dexamethasone sodium phosphate, 1 mg, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Measurement and graphic recording of total and timed exhaled air capacity, Removal of impact ear wax, one ear, Administration of influenza virus vaccine, Administration of pneumococcal vaccine, Aspiration and/or injection of large joint or joint capsule and Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration.

The practitioner is affiliated to the following hospital(s): SIBLEY MEMORIAL HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on December 13, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.