AMMIEL CALLUM – Primary Care Nurse Practitioner, NPI 1467048926

AMMIEL CALLUM is a healthcare provider. based in Elizabeth, New Jersey. specializing in NURSE PRACTITIONER. They hold a License No. F309810 (NY). The NPI Number for AMMIEL CALLUM is 1467048926

Main info

Female
6 Years Of Experience
Name
AMMIEL CALLUM
NPI
1467048926
Phone
(718) 864-6962
Address
351 S BROAD ST APT 305
Enumeration Date
17 December 2020
Last Update Date
17 December 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2122896650206
Graduation Year
2020 (6 years ago)
PAC ID
0547662280
Group Practice PAC ID
8628194842
Professional Enrollment ID
I20210716002072
Address ID
NY100352231NE2265XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

7,574 NURSE PRACTITIONER in NJ

Provider Addresses for AMMIEL CALLUM

  • 351 S BROAD ST APT 305

    ELIZABETH, NJ 072025516

    Phone: (718) 864-6962

    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)

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: 2021-07-16

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
I20210716002072INurse PractitionerNYTBD

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 07202)

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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: 8628194842View full group profile
NameSpecialtyState
O P T O M E T R YNY
Family PracticeNY
Cardiovascular Disease (Cardiology), Internal MedicineNY
O B S T E T R I C S/ G Y N E C O L O G YNY
Nurse PractitionerNY
Family PracticeNY
Internal MedicineNY
Nurse PractitionerNY
Nurse PractitionerNY
Internal MedicineNY

Reviews

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Frequently asked questions

What is AMMIEL CALLUM's NPI number?
AMMIEL CALLUM's NPI is 1467048926 — the number used across U.S. healthcare to identify this provider.
Is there an active status for AMMIEL CALLUM?
For scheduling context, AMMIEL CALLUM is shown as active in the registry.
How would a patient describe AMMIEL CALLUM's focus?
For AMMIEL CALLUM, the primary taxonomy reads as Primary Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is AMMIEL CALLUM located near Elizabeth?
AMMIEL CALLUM currently maps to Elizabeth, New Jersey in this extract.
Can I trust this NPI listing for AMMIEL CALLUM?
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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