MR. KEITH MICHAEL MCCULLOUGH PA-C
NPI 1447800552
Physician Assistant in Coeur D Alene, ID

Q: What is Keith Mccullough's NPI number?

The NPI number for Keith Mccullough is 1447800552. It was assigned to this individual provider in the NPPES registry on September 19, 2019.

Q: What is Keith Mccullough's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Keith Mccullough was last updated on August 3, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 19, 2019PECOS EnrolledAccepts Medicare Assignment

700 W IRONWOOD DR STE 175, COEUR D ALENE, ID 83814(208) 625-6300(208) 625-6301 Get Directions Write a Review

NPPES record last updated: August 3, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 23, 2024, Sep 19, 2019 (2 updates tracked since 2019).

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About Mr. Keith Michael Mccullough Pa-c NPPES

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

MR. KEITH MICHAEL MCCULLOUGH PA-C (NPI 1447800552) is an individual physician assistant in Coeur D Alene, Idaho, licensed in Idaho (PA-1818) and active in the NPI registry since September 2019. He is enrolled in Medicare PECOS, is affiliated with Kootenai Health, and maintains a secondary practice location in Coeur D Alene.

NPPES Registry Identity

NPI1447800552

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. KEITH MICHAEL MCCULLOUGHCredential: PA-C

Location Address700 W IRONWOOD DR STE 175Coeur D Alene, ID 83814-4401

Mailing Address700 W Ironwood Dr Ste 175Coeur D Alene, ID 83814-4401 · (208) 625-6309 · Fax (208) 625-6310

Phone(208) 625-6300

Fax(208) 625-6301

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateSeptember 19, 2019

Last NPPES UpdateAugust 3, 20252 updates tracked since enumeration

NPPES CertifiedAugust 3, 2025

✔ NPI 1447800552 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in ID · PA-1818

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

700 W IRONWOOD DR STE 175, Coeur D Alene, ID 83814

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Secondary Practice Location 1

Location 12003 Kootenai Health WayCoeur D Alene, ID 83814-6051 · Phone (208) 625-6360 · Fax (208) 625-6361

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.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

Mr. Keith Michael Mccullough Pa-c 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 ID9436582566

PECOS Enrollment IDI20191204001152

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.

Areas of Expertise CMS Part B claims 14

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.

Drainage of fluid from abdominal cavity using imaging guidance 49083

This procedure involves removing excess fluid from your abdominal cavity, which can relieve discomfort. A specialist uses imaging technology to guide a thin needle into the right spot. The fluid is then drained out safely.

89 services30 patients

Aspiration of fluid from chest cavity using imaging guidance 32555

This procedure, known as a thoracentesis, involves removing fluid from the space between the lungs and chest wall, called the pleural space. It's performed under imaging guidance to ensure precision. It can help diagnose conditions or relieve symptoms like shortness of breath.

59 services46 patients

Fluoroscopic guidance for needle placement 77002

Fluoroscopic guidance for needle placement is a medical procedure that uses a special X-ray technology to help accurately place a needle in the body. It's often used in biopsies, injections or other treatments to ensure precision and safety.

42 services42 patients

Review by radiologist of ct guidance for needle placement 77012

This process involves a radiologist examining CT scan images to accurately guide a needle's placement within the body. This technique is often used for biopsies or treatments, ensuring precision and safety.

40 services39 patients

Biopsy and aspiration of bone marrow sample for diagnosis 38222

A bone marrow biopsy and aspiration is a procedure where a small amount of bone marrow is removed for testing. It involves inserting a needle into a bone, typically the hip, to collect a sample. It can help diagnose various diseases and monitor treatment effectiveness.

38 services37 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

33 services32 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

30 services29 patients

Fine needle aspiration biopsy using ultrasound guidance, first growth 10005

Fine needle aspiration biopsy with ultrasound guidance is a procedure where a thin needle is inserted into a growth to extract a small sample. Ultrasound helps accurately locate the growth. This sample is then analyzed to determine the nature of the growth.

25 services25 patients

Ultrasonic guidance for needle placement 76942

Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.

17 services17 patients

Removal of spinal fluid with lower back spinal tap for diagnostic test using imaging guidance 62328

A lower back spinal tap, guided by imaging, is a procedure to collect spinal fluid for testing. A needle is carefully inserted into the lower back to draw out fluid. This can help diagnose various conditions. It's performed under local anesthesia to minimize discomfort.

14 services14 patients

Needle biopsy or removal of surface lymph nodes 38505

A needle biopsy or removal of surface lymph nodes is a procedure where a small needle is inserted into a lymph node to collect a tissue sample. This sample is then examined under a microscope to check for diseases such as cancer. The procedure is usually quick and minimally invasive.

12 services12 patients

Injection of contrast for imaging of lower spinal canal 62284

This procedure involves injecting a special dye, called contrast, into your lower spine. The contrast helps create clearer images of your spinal canal during imaging tests. It aids in identifying any abnormalities or issues more effectively.

12 services12 patients

Fluoroscopic guidance for spine or back muscle injection 77003

Fluoroscopic guidance for spine or back muscle injection is a procedure where a special X-ray technology, called fluoroscopy, is used to help accurately place the needle for an injection in the spine or back muscles. This ensures precise delivery of medication to the targeted area.

12 services12 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Kootenai Health

Acute Care Hospitals · Coeur D'alene, ID

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number130049

Location2003 Kootenai Health WayCoeur D'alene, ID 83814 · Kootenai County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83814 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$65.77 typical visit price

range $16.68 – $130.93

Typical copayment $16.44 (range $4.17 – $32.73)

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.

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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.

DR. BRIAN JOSEPH MCNAMEE MD

Radiology (Diagnostic Radiology)