AMANDA GAYLE MCCULLOUGH (PT) – Physical Therapist, NPI 1629013602

AMANDA GAYLE MCCULLOUGH (PT) is a healthcare provider. based in Clare, Michigan. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 5501011835 (MI). The NPI Number for AMANDA GAYLE MCCULLOUGH (PT) is 1629013602

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA GAYLE MCCULLOUGH (PT)
NPI
1629013602
Phone
(989) 386-9170
Address
107 SCHOOLCREST AVE
Enumeration Date
17 June 2006
Last Update Date
26 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8107014633
Graduation Year
2003 (23 years ago)
PAC ID
2062475189
Group Practice PAC ID
3274864665
Professional Enrollment ID
I20041110000141
Address ID
MI494289002JE1725XSTXX400

Contacts

Main Contact
https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

3,459 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MI

Loading map...

Provider Addresses for AMANDA GAYLE MCCULLOUGH (PT)

  • Schoolcrest Avenue, Clare, Grant Township, Clare County, Michigan, 48617, United States

    CLARE, MI 486171145

    Phone: (989) 386-9170

    Fax: (989) 386-9220

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2004-11-10

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20041110000141IPhysical Therapist In Private PracticeMITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48617)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3274864665View full group profile
NameSpecialtyState
Qualified Speech Language PathologistMI
-PA
Occupational Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Occupational Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Qualified Speech Language PathologistMI

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is the standard ID for AMANDA GAYLE MCCULLOUGH (PT) in the U.S.?
In the U.S., AMANDA GAYLE MCCULLOUGH (PT) is identified by NPI 1629013602.
Quick check: is AMANDA GAYLE MCCULLOUGH (PT) active?
Public NPPES data shows AMANDA GAYLE MCCULLOUGH (PT) with an active NPI status right now.
What does the directory say AMANDA GAYLE MCCULLOUGH (PT) does?
Insurance directories may phrase it differently, but here AMANDA GAYLE MCCULLOUGH (PT) maps to Physical Therapist. Clinical services aligned with this taxonomy classification.
Which community is linked to AMANDA GAYLE MCCULLOUGH (PT)?
AMANDA GAYLE MCCULLOUGH (PT) shows a connection to Clare, Michigan in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

Similar Providers

Schoolcrest Avenue, Clare, Clare County, Michigan, 48617, United States
NPI: 1659330702

PATRICK L HOWE (DPT)

Physical Therapist
Schoolcrest Avenue, Clare, Clare County, Michigan, 48617, United States
NPI: 1417916560
Schoolcrest Avenue, Clare, Grant Township, Clare County, Michigan, 48617, United States
NPI: 1295740637
3100 N CONCOURSE DR
NPI: 1518025642
8900 S BRINTON RD
NPI: 1356409361
MidMichigan Medical Center - Clare, 703, North McEwan Street, Clare, Clare County, Michigan, 48617, United States
NPI: 1548450133

MR. TOD A LEESON (P.T.)

Physical Therapist
PO BOX 420
NPI: 1033380852

HETTY TOMS (PT)

Physical Therapist
MidMichigan Medical Center - Clare, 703, North McEwan Street, Clare, Clare County, Michigan, 48617, United States
NPI: 1710118922
107 SCHOOLCREST AVE
NPI: 1831466457