DR. KIM LESLIE MCCULLOUGH (M.D.) – Surgery Physician, NPI 1194777680

DR. KIM LESLIE MCCULLOUGH (M.D.) is a healthcare provider. based in Sault sainte marie, Michigan. specializing in GENERAL SURGERY. They hold the professional credentials M.D.. They hold a License No. KM405465 (MI). The NPI Number for DR. KIM LESLIE MCCULLOUGH (M.D.) is 1194777680

Main info

Male
Sole Proprietor
42 Years Of Experience
Accepts Medicare Assignment
Name
DR. KIM LESLIE MCCULLOUGH (M.D.)
NPI
1194777680
Phone
(906) 635-1048
Address
550 OSBORN BLVD
Enumeration Date
16 May 2006
Last Update Date
22 February 2010

Doctor Profile

Medical School Name
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Secondary Phone
9066351048
Graduation Year
1984 (42 years ago)
PAC ID
2769676006
Professional Enrollment ID
I20101101001022
Address ID
MI497831852SA550XXBLVD304
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,452 GENERAL SURGERY in MI

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Provider Addresses for DR. KIM LESLIE MCCULLOUGH (M.D.)

  • 550, Osborn Boulevard, Sault Ste. Marie, Chippewa County, Michigan, 49783, United States

    SUITE 2600

    SAULT SAINTE MARIE, MI 497831899

    Phone: (906) 635-1048

    Fax: (906) 635-3103

    Mailing address matches the actual address.

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 $43.

Total Amount is formed as General ($43) + Research ($0) + Ownership ($0) = $43.

Last reported payment date: 2024-01-18 • Largest payer in this snapshot: Olympus America Inc. ($43).

Total Amount

$43

General + Research + Ownership

Payments

1

Total payment records

General Amount

$43

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-18

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Olympus America Inc.$43
View all Open Payments →|Open Payments Risk Radar →

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: 2010-11-01

PECOS data refreshed: 2026-06-15

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20101101001022IGeneral SurgeryMITBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes8983$0
99203New patient office or other outpatient visit, 30-44 minutes6666$0
45380Biopsy of large bowel using a flexible endoscope4848$0
99214Established patient office or other outpatient visit, 30-39 minutes4742$0
99204New patient office or other outpatient visit, 45-59 minutes3333$0
View full utilization report →

Insurance plans in this area (ZIP 49783)

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Reviews

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Frequently asked questions

Is DR. KIM LESLIE MCCULLOUGH (M.D.) listed with a National Provider Identifier?
Yes — DR. KIM LESLIE MCCULLOUGH (M.D.) has NPI 1194777680 on file in the registry.
Is DR. KIM LESLIE MCCULLOUGH (M.D.) still an active registrant?
DR. KIM LESLIE MCCULLOUGH (M.D.) carries an active NPI according to the public dataset.
What clinical focus is listed for DR. KIM LESLIE MCCULLOUGH (M.D.)?
At a glance, DR. KIM LESLIE MCCULLOUGH (M.D.) is tied to Surgery Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. KIM LESLIE MCCULLOUGH (M.D.)?
Travel planning: use Sault Sainte Marie, Michigan as the reference point for DR. KIM LESLIE MCCULLOUGH (M.D.), then confirm.
Can I trust this NPI listing for DR. KIM LESLIE MCCULLOUGH (M.D.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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