Alan Reid Bullock, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

16618 Issued in AZ

Practice address

4582 N 1St Ave
Suite 170
Tucson, AZ 85718-8603

Phone

(520) 318-6035

Fax

(520) 795-9953

NPI assigned

Aug 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: clinical@pisapain.directbygreenway.com

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.

• Southern Arizona Anesthesia Services, PC

  • Anesthesiology Physician
  • Tucson, AZ
  • NPI 1912999343
  NPD (past)

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1033101712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 E CAMP LOWELL DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857121256",
            "telephone_number": "520-731-5540",
            "fax_number": "520-731-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4582 N 1ST AVE",
            "address_2": "SUITE 170",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857188603",
            "telephone_number": "520-318-6035",
            "fax_number": "520-795-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "ALAN",
        "middle_name": "REID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "16618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277807",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elena Marie Bulger, MSN
• Amir I Buljina, MD
• Lynette Bullard, CNM
• Cindi Lou Buller
• Phillip Wade Bullington
• Brenna Bullock
• Josie Monique Bullock
• Kelly Anne Bultemeier, MED, ATC/L, CES
• Kent Bultemeier
• Jenna Bumgardner, PA

• Specialist in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.