MARY POLLEYS MCCULLOCH NNP
NPI 1275672396
Nurse Practitioner - Neonatal, Critical Care in Boise, ID
About Mary Polleys Mcculloch Nnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY POLLEYS MCCULLOCH NNP (NPI 1275672396) is an individual neonatal, critical care provider in Boise, Idaho, licensed in Idaho (58268) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (1982).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mary Polleys Mcculloch Nnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 83712 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
BOISE, ID 83712
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 Mary Mcculloch's NPI number?
The NPI number for Mary Mcculloch is 1275672396. It was assigned to this individual provider in the NPPES registry on February 5, 2007.
Where is Mary Mcculloch located?
Mary Mcculloch practices at 190 E Bannock St, Boise, ID 83712. The listed phone number is (208) 381-2088.
What is Mary Mcculloch's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Neonatal, Critical Care, with taxonomy code 363LN0005X.
Is Mary Mcculloch enrolled in Medicare?
Yes. Mary Mcculloch is registered in the Medicare PECOS enrollment system.
What insurance does Mary Mcculloch accept?
Health plans from Providence Health Plan and Select Health list Mary Mcculloch 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.
When was this NPI record last updated?
The NPPES record for Mary Mcculloch was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.
# Mary Polleys Mcculloch, NNP · NPI 1275672396
Neonatal, Critical Care physician in Boise, Idaho. Individual provider, active in the CMS NPPES registry since February 5, 2007.
## Identity
- **NPI:** 1275672396 (Entity type: Individual)
- **Enumerated:** February 5, 2007
- **Primary specialty:** Nurse Practitioner - Neonatal, Critical Care · taxonomy 363LN0005X
- **State license:** 58268 (Idaho)
- **Sole proprietor:** No
## Practice location
- **Address:** 190 E BANNOCK ST, Boise, ID 83712-6241
- **Phone:** (208) 381-2088
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 1982
## Record status
- **NPPES last updated:** April 27, 2026
- **Other identifiers:** Medicaid 176667 (AZ)
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Source: [NPI Profile](https://npiprofile.com/npi/1275672396) · Data from the CMS NPPES public registry.