Individual provider Active NPI

Gaelle Maviluka Bulabula

  • Family Nurse Practitioner
  • Carmel, IN
National Provider Identifier
1003523846
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71013415A Issued in IN
Practice address
13090 Petigru Dr
Carmel, IN 46032-4436
Phone
(317) 733-8608
NPI assigned
Nov 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71013415A IN Primary

Addresses

Primary practice location

13090 Petigru Dr
Carmel, IN 46032-4436

Mailing address

2620 Elm Hill Pike
Nashville, TN 37214-3108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.89 of 100Reported as group
Quality
67.99
Promoting interoperability
100
Improvement activities
40
Cost
78.32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71013415AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Little Clinic of in LLC Family CurrentSince Jan 3, 2023 Accepting new patients

Locations

1217 S Rangeline Rd
Carmel, IN 46032
Phone (317) 574-4680

11700 Olio Rd
Fishers, IN 46037
Phone (317) 436-4950

815 Highlander Point Dr
Floyds Knobs, IN 47119
Phone (812) 923-7146

Interoperability endpoints

  • Direct secure messaging: gaelle.bulabula@krogerhealth.eclinicaldirectplus.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1003523846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 ELM HILL PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13090 PETIGRU DR",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460324436",
            "telephone_number": "317-733-8608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULABULA",
        "first_name": "GAELLE",
        "middle_name": "MAVILUKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-01",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71013415A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.