Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kevin McCullum, MD

Individual provider Family Medicine Physician · NPI 1063518975

Kevin McCullum, MD is a Family Practice in Plattsburgh, New York. Graduated from Rutgers R W Johnson Medical School (CAM/NEW Bruns/Pisc) in 1984, 42 years ago. Practices with Champlain Valley Physicians Hospital Medical Center, a 352-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
42
Trained at
Rutgers R W Johnson Medical School (CAM/NEW Bruns/Pisc)
Licensed in
NY
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

96 Court St
Plattsburgh, NY 12901-2733
Phone: (518) 562-1080
Fax: (518) 562-3316
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 164868 (NY)

Record details

NPI number1063518975
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedSeptember 16, 2006
Last updated in NPPESFebruary 18, 2020
Certification dateFebruary 18, 2020
Mailing address154 Prospect Ave, Plattsburgh, NY 12901-1302

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolRUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC)
Graduated 1984 (42 years in practice)
Group practice Champlain Valley Physicians Hospital Medical Center — 352 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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