Nicole Elisabeth McCullough, PA-C

NPI 1497388441ActiveIndividual· Physician Assistant, Medical· Swartz Creek, MI

Physician Assistant, Medical (PA-C) with Legacy Physician Group PC and 1 other group, practicing in Swartz Creek, Michigan. 224 Medicare patients in 2024, $24,653 paid; nearly all of their 1,542 Part D prescriptions were generic (96%).

Overview

NPI	1497388441
Status	Active
Entity type	Individual
Credential	PA-C
Sole proprietor	Yes
NPI issued	Feb 18, 2020
Last updated in NPPES	Apr 7, 2021
Certified by provider	Apr 7, 2021

Specialties and licenses

Taxonomy	Code	License	State
Physician Assistant, Medical Primary	363AM0700X	5601009723	MI

About license numbers in NPPES

Exclusion screening

List	Result	Details
HHS-OIG LEIE · Nov 10, 2026	No match	Checked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026	No match	—
New York OMIG · Nov 11, 2026	No match	—
Ohio Medicaid · Nov 11, 2026	No match	—
Pennsylvania Medicheck · Nov 11, 2026	No match	—
Washington HCA · Nov 11, 2026	No match	—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)	Enrolled Practitioner - Physician Assistant (MI)
Accepts assignment	Yes (participating)

Medicare services in 2024

Medicare patients	224
Services billed	1,167 across 65 procedure codes
Paid by Medicare	$24,653

Part D prescriptions in 2024

Prescriptions (claims)	1,542 · 1,615 30-day fills
Patients	731
Total drug cost	$12,875
Generic share	96% of claims

Medicare sources and data years

Education and affiliations

Graduation year	2019
Medicare specialty	Physician Assistant

Medical groups

Legacy Physician Group PCLansing, MI · 11 clinicians
Clio Urgent Care PLLCClio, MI · 10 clinicians

Source: CMS Care Compare

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records