Individual provider Active NPI

John Bulko

  • Clinical Social Worker
  • Battle Creek, MI
National Provider Identifier
1023542842
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801106731 Issued in MI
Practice address
140 Michigan Ave W
Battle Creek, MI 49017-3602
Phone
(269) 966-1460
Fax
(269) 966-2844
NPI assigned
Apr 18, 2017
Last updated
Apr 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801097124 MI
Clinical Social Worker 1041C0700X 6801106731 MI Primary

Addresses

Primary practice location

140 Michigan Ave W
Battle Creek, MI 49017-3602

Mailing address

2700 E Centre Ave
Portage, MI 49002-5500
Phone (269) 286-7050

Other identifiers 1

IdentifierTypeStateIssuer
6801097124OtherMILICENSE #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200423001556 MI Practitioner - Clinical Social Worker 5597195032 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

2700 E Centre Ave
Portage, MI 49002-5500
Phone (269) 286-7051

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
75.38
Promoting interoperability
100
Improvement activities
40
Cost
79.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801097124MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Battle Creek Hospital CurrentSince Apr 26, 2021 Accepting new patients
Bronson South Haven Hospital CurrentSince Apr 26, 2021 Accepting new patients
Bronson Lakeview Hospital CurrentSince Apr 26, 2021 Accepting new patients
Bronson South Haven Hospital CurrentSince Apr 26, 2021 Accepting new patients
Bronson Methodist Hospital CurrentSince Apr 26, 2021 Accepting new patients
Summit Pointe Clinical CurrentSince Mar 20, 2020 Accepting new patients
Bronson Battle Creek Hospital CurrentSince Apr 26, 2021 Accepting new patients
Bronson Lakeview Hospital CurrentSince Apr 26, 2021 Accepting new patients

Locations

8472 Reliable Pkwy
Chicago, IL 60686

520 Railroad St
Bangor, MI 49013
Phone (269) 427-5811

140 Michigan Ave W
Battle Creek, MI 49017
Phone (269) 966-1460

2900 Watkins Rd
Battle Creek, MI 49015
Phone (269) 245-5430

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

2700 E Centre Ave
Portage, MI 49002
Phone (269) 286-7050

950 S Bailey Ave
South Haven, MI 49090
Phone (269) 639-2796

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 8

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1023542842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 E CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490025500",
            "telephone_number": "269-286-7050",
            "fax_number": "269-286-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 MICHIGAN AVE W",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173602",
            "telephone_number": "269-966-1460",
            "fax_number": "269-966-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULKO",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-18",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801097124",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801106731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "6801097124",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.