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DR. KIM LESLIE MCCULLOUGH M.D.
NPI 1194777680
Surgery in Sault Sainte Marie, MI

Active since May 16, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 23D0881703 · Waiver
20.63/100
CMS Quality Rating
550 OSBORN BLVD, SUITE 2600, SAULT SAINTE MARIE, MI 49783(906) 635-1048(906) 635-3103 Get Directions Write a Review

NPPES record last updated: February 22, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Kim Leslie Mccullough M.d. NPPES

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

DR. KIM LESLIE MCCULLOUGH M.D. (NPI 1194777680) is an individual surgery provider in Sault Sainte Marie, Michigan, licensed in Michigan (KM405465) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through January 16, 2028, and is affiliated with Chippewa County War Memorial Hospital.

NPPES Registry Identity

NPI1194777680
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. KIM LESLIE MCCULLOUGHCredential: M.D.
Location Address550 OSBORN BLVD, SUITE 2600Sault Sainte Marie, MI 49783-1899
Mailing Address550 Osborn Blvd, Suite 2600Sault Sainte Marie, MI 49783-1899 · (906) 635-1048 · Fax (906) 635-3103
Phone(906) 635-1048
Fax(906) 635-3103
Sole ProprietorYes
Medical School CMSUniversity Of Michigan Medical SchoolGraduated 1984
Enumeration DateMay 16, 2006
Last NPPES UpdateFebruary 22, 2010
✔ NPI 1194777680 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in MI · KM405465
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
550 OSBORN BLVD, Sault Sainte Marie, MI 49783
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Other Identifiers 4

Other382967127MI · Tax Identification
Medicare UPINE56536MI
Medicare ID-Type Unspecified0170028MI
Medicaid2698385MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.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

Dr. Kim Leslie Mccullough M.d. 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 ID2769676006
PECOS Enrollment IDI20101101001022
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D0881703

Kim Mccullough MD · Sault Sainte Marie, MI
Active · expires Jan 16, 2028
CLIA Number23D0881703
Laboratory TypePhysician Office
Certificate Effective DateJanuary 17, 2026
Certificate Expiration DateJanuary 16, 2028
Laboratory DirectorKim L. Mccullough
Laboratory Phone(906) 635-1048
Laboratory LocationKim Mccullough MD550 Osborn Suite 2600, Sault Sainte Marie, MI 49783
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
75 services72 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
56 services56 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
52 services52 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
42 services39 patients
Colorectal cancer screening; colonoscopy on individual at high risk G0105
Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.
31 services31 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
23 services23 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Chippewa County War Memorial Hospital

Acute Care Hospitals · Sault Sainte Marie, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230239
Location500 Osborn BlvdSault Sainte Marie, MI 49783 · Chippewa County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49783 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

20.63/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0
Cost68.79

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each A5063
DME-Orthotic Devices · category DF010N
2 suppliers11 claims200 services$2.35 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. GORDON KEITH WYMORE DDS
Dentist (General Practice)
550 OSBORN BLVD, SUITE 2603
SAULT SAINTE MARIE, MI 49783
Chippewa County (906) 635-9303
NORTHERN NEUROLOGY, PLLC
Psychiatry & Neurology (Neurology)
550 OSBORN BLVD
SAULT SAINTE MARIE, MI 49783
Chippewa County (906) 253-9136
PHILLIP W. NIEMI, D.O.,P.C.
Family Medicine
550 OSBORN BLVD, SUITE #202
SAULT SAINTE MARIE, MI 49783
Chippewa County (906) 632-1100
EERO J. RANTA, M.D., P.C.
Internal Medicine
550 OSBORN BLVD, SUITE 204
SAULT SAINTE MARIE, MI 49783
Chippewa County (906) 632-6823
PHILLIP W NIEMI D.O.
Family Medicine
550 OSBORN BLVD, SUITE #202
SAULT SAINTE MARIE, MI 49783
Chippewa County (906) 632-1100
JULIE REID CFNP
Nurse Practitioner
550 OSBORN BLVD, SUITE 101
SAULT SAINTE MARIE, MI 49783
Chippewa County (906) 632-0370
CHIPPEWA COUNTY WAR MEMORIAL HOSPITAL INC.
Family Medicine
550 OSBORN BLVD
SAULT SAINTE MARIE, MI 49783
Chippewa County (906) 635-4460
DR. JAMES WILLIAM SAWYER MD
Family Medicine
550 OSBORN BLVD
SAULT SAINTE MARIE, MI 49783
Chippewa County (906) 253-2665

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kim Mccullough's NPI number?

The NPI number for Kim Mccullough is 1194777680. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Where is Kim Mccullough located?

Kim Mccullough practices at 550 Osborn Blvd Suite 2600, Sault Sainte Marie, MI 49783. The listed phone number is (906) 635-1048.

What is Kim Mccullough's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Kim Mccullough enrolled in Medicare?

Yes. Kim Mccullough is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Does Kim Mccullough hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D0881703) is associated with this NPI, valid through January 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kim Mccullough accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Kim Mccullough as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kim Mccullough affiliated with any hospitals?

According to CMS data, Kim Mccullough is affiliated with Chippewa County War Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Kim Mccullough was last updated on February 22, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.