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Kory Mccullah , PA-C

Physician Assistant β€’ Fort Drum, NY

Active NPI 1902598568 Individual Practitioner Male Practitioner
Practice location in NPPES

11050 Mt Belvedere Blvd
Fort Drum, NY 136022603

Call 3157742359 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

11050 Mt Belvedere Blvd

Fort Drum, NY 136022603

Telephone 3157742359

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021–2025.

Guide: How to read an Open Payments record

NPI first issued

2023

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Fort Drum and New York

56 active clinicians are listed under Physician Assistant with a practice address in Fort Drum, NY (15,558 in New York).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Fort Drum

3.6% of these 56 clinicians have the CMS telehealth indicator.

10.7% of these 56 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-06-09
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: New York Office of the Professions.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

8 listed
Tatyana Armstead , FNP

Nurse Practitioner - Family

NPI 1538620133

Family Nurse Practitioner

Dr. Andrew Kosmowski , MD

Emergency Medicine

NPI 1629051727

Doctor of Medicine (M.D.)

Gregory Pataky , APA-C

Physician Assistant - Medical

NPI 1821076324

APAC

NPI 1639493562

Doctor of Chiropractic

Dr. Andrew Place , PT, DPT

Physical Therapist

NPI 1487109294

Physical Therapist, Doctor of Physical Therapy

Dr. Tristan Seok , DPT

Physical Therapist

NPI 1447671821

Doctor of Physical Therapy

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location June 09, 2026

Registered at 11050 MT BELVEDERE BLVD, FORT DRUM, NY 136022603 (Tel: 3157742359)

πŸ“
Updated Business Mailing Address June 09, 2026

Registered at 5187 STATE HIGHWAY 56, COLTON, NY 136257785 (Tel: 9077999792)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 09, 2026

Physician Assistant

βœ…
NPI Profile Active May 23, 2023

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) May 23, 2023

Registered at 50 IDLEWILD RD, MARLBORO, NY 125425533 (Tel: 9077999792)

πŸ“
Business Mailing Address (Initial Record) May 23, 2023

Registered at 50 IDLEWILD RD, MARLBORO, NY 125425533 (Tel: 9077999792)

πŸ‘€
Provider Name / Credentials (Initial Record) May 23, 2023

Recorded as KORY MCCULLAH, PA-C

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 23, 2023

Physician Assistant (license number reported to NPPES: NY 1208115)

🟒
Initial NPI Registration & Enumeration May 23, 2023

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1902598568
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 23, 2023
Last Update: June 09, 2026
Sole Proprietor: Yes

Other Physician Assistants in Fort Drum

All Physician Assistants in Fort Drum

Mailing Address

5187 State Highway 56

Colton, NY 136257785

Phone: 9077999792

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.