Cullen Anthony Mack, PA-C
NPI 1104369099ActiveIndividual· Physician Assistant· Central Point, OR
Physician Assistant (PA-C) with Providence Health and Services Oregon, practicing in Central Point, Oregon. 415 Medicare patients in 2024, $37,808 paid; nearly all of their 736 Part D prescriptions were generic (96%). Lists Providence Medford Medical Center as a hospital affiliation.
Overview
| NPI | 1104369099 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Nov 23, 2016 |
| Last updated in NPPES | Aug 20, 2026 |
| Certified by provider | Aug 20, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | PA180563 | OR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (OR) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 415 |
|---|---|
| Services billed | 1,452 across 70 procedure codes |
| Paid by Medicare | $37,808 |
Part D prescriptions in 2024
| Prescriptions (claims) | 736 · 778 30-day fills |
|---|---|
| Patients | 467 |
| Total drug cost | $8,289 |
| Generic share | 96% of claims |
Education and affiliations
| Graduation year | 2016 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Providence Health and Services OregonMedford, OR · 170 clinicians
Hospital affiliation
- Providence Medford Medical CenterMedford, OR
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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