BRIAN CLANCY TULLOH PA-C
NPI 1972213148
Physician Assistant in South Portland, ME

Q: What is Brian Tulloh's NPI number?

The NPI number for Brian Tulloh is 1972213148. It was assigned to this individual provider in the NPPES registry on November 29, 2022.

Q: What is Brian Tulloh'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 Brian Tulloh was last updated on September 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since November 29, 2022PECOS EnrolledAccepts Medicare Assignment

265 WESTERN AVE STE 2, SOUTH PORTLAND, ME 04106(207) 661-0200(207) 661-0299 Get Directions Write a Review

NPPES record last updated: September 3, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 3, 2025, Nov 29, 2022 (2 updates tracked since 2022).

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About Brian Clancy Tulloh Pa-c NPPES

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

BRIAN CLANCY TULLOH PA-C (NPI 1972213148) is an individual physician assistant in South Portland, Maine, licensed in Maine (PA2930) and active in the NPI registry since November 2022. He is enrolled in Medicare PECOS, is affiliated with Maine Medical Center, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1972213148

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameBRIAN CLANCY TULLOHCredential: PA-C

Location Address265 WESTERN AVE STE 2South Portland, ME 04106-2458

Mailing Address265 Western Ave Ste 2South Portland, ME 04106-2458 · (207) 661-0200 · Fax (207) 661-0299

Phone(207) 661-0200

Fax(207) 661-0299

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateNovember 29, 2022

Last NPPES UpdateSeptember 3, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 3, 2025

✔ NPI 1972213148 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in ME · PA2930✔ Licensed in NH · 2961

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.

265 WESTERN AVE STE 2, South Portland, ME 04106

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Secondary Practice Locations 4

Location 13073 White Mountain HwyNorth Conway, NH 03860-7101 · Phone (603) 356-4904 · Fax (603) 356-0842

Location 2450 Brookline AveBoston, MA 02215-5418 · Phone (617) 632-4524

Location 327 Industrial Ave Ste 101Sanford, ME 04073-5846 · Phone (207) 459-1666 · Fax (207) 661-8537

Location 41 Medical Center DrLebanon, NH 03756-0001 · Phone (603) 650-5000

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

Brian Clancy Tulloh 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 ID8426428434

PECOS Enrollment IDI20251119001195

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.

Hospital Affiliations CMS Care Compare

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

Maine Medical Center

Acute Care Hospitals · Portland, ME

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number200009

Location22 Bramhall StPortland, ME 04102 · Cumberland County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04106 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

$86.72 typical visit price

range $56.28 – $169.96

Typical copayment $21.68 (range $14.07 – $42.49)

Most-billed visit code 99203

Established Patient

$70.13 typical visit price

range $18.22 – $138.92

Typical copayment $17.53 (range $4.55 – $34.73)

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.

PAMELA EGAN M.D.

Internal Medicine (Hematology & Oncology)