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ADULT & PEDIATRIC UROLOGY, LLC
NPI 1710190350
Urology in Farmington, NM

Active since May 08, 2007
2300 E 30TH ST, BLDG B SUITE 106, FARMINGTON, NM 87401(505) 327-9111(505) 327-2730 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Adult & Pediatric Urology, Llc NPPES

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

ADULT & PEDIATRIC UROLOGY, LLC (NPI 1710190350) is a healthcare organization registered as an urology in Farmington, New Mexico and active in the NPI registry since May 2007. The organization lists Allen W Mcculloch, Owner, as its authorized official.

NPPES Registry Identity

NPI1710190350
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameADULT & PEDIATRIC UROLOGY, LLC
Location Address2300 E 30TH ST, BLDG B SUITE 106Farmington, NM 87401-8990
Mailing Address2300 E 30th St, Bldg B Suite 106Farmington, NM 87401-8990 · (505) 327-9111 · Fax (505) 327-2730
Phone(505) 327-9111
Fax(505) 327-2730
Organization SubpartNo
Authorized OfficialAllen W MccullochOwner · (505) 327-9111
Enumeration DateMay 8, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1710190350 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License✔ Licensed in NM · 87115
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
2300 E 30TH ST, Farmington, NM 87401
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Adult & Pediatric Urology, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNew MexicoEnrollment IDO20091109000478Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Adult & Pediatric Urology, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Allen Mcculloch, MD
Urology
NPI 1881778215
2300 E 30TH BLDG B SUITE 106
Farmington, NM 87401
(505) 327-9111
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Adult & Pediatric Urology, LLC's NPI number?

The NPI number for Adult & Pediatric Urology, LLC is 1710190350. It was assigned to this organization in the NPPES registry on May 8, 2007.

Where is Adult & Pediatric Urology, LLC located?

Adult & Pediatric Urology, LLC is located at 2300 E 30th St Bldg B Suite 106, Farmington, NM 87401. The listed phone number is (505) 327-9111.

What is Adult & Pediatric Urology, LLC's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Adult & Pediatric Urology, LLC enrolled in Medicare?

Yes. Adult & Pediatric Urology, LLC is registered in the Medicare PECOS enrollment system.

When is Adult & Pediatric Urology, LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New Mexico, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Adult & Pediatric Urology, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Urology) reassigns their Medicare billing to Adult & Pediatric Urology, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Adult & Pediatric Urology, LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.