MARTY MCCULLOUGH (CRNA) – Certified Registered Nurse Anesthetist, NPI 1366678575
Certified Registered Nurse Anesthetist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,359 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in FL
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Provider Addresses for MARTY MCCULLOUGH (CRNA)
St Augustine Post Office, 34, Main Street, St. Augustine, Knox County, Illinois, 61474, United States
ST AUGUSTINE, FL 320853123
Phone: (904) 824-4990
Fax: (904) 824-2226
Type: Mailing
Putnam Community Medical Center, 611, Zeagler Drive, Palatka, Putnam County, Florida, 32177, United States
PALATKA, FL 321773810
Phone: (386) 326-7865
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $19.
Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.
Last reported payment date: 2023-03-15 • Largest payer in this snapshot: KCI USA, Inc. ($19).
Total Amount
$19
General + Research + Ownership
Payments
1
Total payment records
General Amount
$19
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| KCI USA, Inc. | $19 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-07-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100716000770 | I | Certified Registered Nurse Anesthetist (Crna) | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 00142 | Anesthesia for lens surgery | 53 | 47 | $0 |
| 00520 | Anesthesia for other closed procedure on chest | 14 | 13 | $0 |
Insurance plans in this area (ZIP 32085)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| CERTIFIED REGISTERED NURSE ANESTHET | FL | 00790 | Anesthesia for procedure in upper abdomen including use of an endoscope | 16 | 15 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| - | FL | |
| Family Practice | FL | |
| A N E S T H E S I O L O G Y | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
| - | FL | |
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| - | FL |
Reviews
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