DR. ALEXIS MAKIKO MCCULLOUGH OD
NPI 1942871645
Optometrist in San Diego, CA
About Dr. Alexis Makiko Mccullough Od NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. ALEXIS MAKIKO MCCULLOUGH OD (NPI 1942871645) is an individual optometrist in San Diego, California, licensed in California (34810) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS and is a graduate of Southern California College Of Optometry (2020).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Alexis Makiko Mccullough Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
6Medicare enrollment records show Alexis Mccullough reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Diego, CA 92128
- Reassigned Medicare billing, California enrollment
- 236 clinicians in this Medicare group
Monterey, CA 93940
- Reassigned Medicare billing, California enrollment
- 18 clinicians in this Medicare group
Susanville, CA 96130
- Reassigned Medicare billing, California enrollment
- 38 clinicians in this Medicare group
Omaha, NE 68114
- Reassigned Medicare billing, Nebraska and Minnesota enrollments
- Also billed through NPI 1881962173 (Minnesota)
- 21 clinicians in this Medicare group
Hudson, WI 54016
- Reassigned Medicare billing, Wisconsin enrollment
- 187 clinicians in this Medicare group
Wisconsin Rapids, WI 54494
- Reassigned Medicare billing, Wisconsin enrollment
- 102 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92122 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Alexis Mccullough's NPI number?
The NPI number for Alexis Mccullough is 1942871645. It was assigned to this individual provider in the NPPES registry on July 5, 2021.
Where is Alexis Mccullough located?
Alexis Mccullough practices at 4353 La Jolla Village Dr Ste H-20, San Diego, CA 92122. The listed phone number is (858) 622-2165.
What is Alexis Mccullough's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Alexis Mccullough enrolled in Medicare?
Yes. Alexis Mccullough is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Alexis Mccullough's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Alexis Mccullough reassigns Medicare benefits to 6 organizations: Total Vision PC (San Diego, CA), Eyemd On Cass A Professional Corporation (Monterey, CA), Troy Humphreys Od Faao, Professional Corporation (Susanville, CA), Visionworks, Inc. (Omaha, NE), Shoptikal LLC (Hudson, WI) and 1 more organization, listed in the Medicare section above. Each 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 Alexis Mccullough's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Alexis Mccullough accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 4 other insurers list Alexis 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.
When was this NPI record last updated?
The NPPES record for Alexis Mccullough was last updated on July 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Dr. Alexis Makiko Mccullough, OD · NPI 1942871645
Optometrist provider in San Diego, California. Individual provider, active in the CMS NPPES registry since July 5, 2021.
## Identity
- **NPI:** 1942871645 (Entity type: Individual)
- **Enumerated:** July 5, 2021
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 34810 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 4353 LA JOLLA VILLAGE DR STE H-20, San Diego, CA 92122-1242
- **Phone:** (858) 622-2165
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 6 organizations under Medicare reassignment (form CMS-855R): Total Vision PC (NPI 1356813711, San Diego, CA); Eyemd On Cass A Professional Corporation (NPI 1205095742, Monterey, CA); Troy Humphreys Od Faao, Professional Corporation (NPI 1326660960, Susanville, CA); Visionworks, Inc. (NPI 1619006327, Omaha, NE); Shoptikal LLC (NPI 1851982771, Hudson, WI); and 1 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Southern California College Of Optometry, class of 2020
## Record status
- **NPPES last updated:** July 5, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1942871645) · Data from the CMS NPPES public registry.