Individual provider Active NPI

Kandace Marie Bullajian, RN, MSN, FNP-BC

  • Family Nurse Practitioner
  • Waco, TX
National Provider Identifier
1033306303
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP116267 Issued in TX
Practice address
7300 Bosque Blvd
Waco, TX 76710-4023
Phone
(254) 202-2600
Fax
(254) 202-2650
NPI assigned
Oct 1, 2007
Last updated
Dec 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP116267 TX Primary
Family Nurse Practitioner 363LF0000X 720770 TX

Addresses

Primary practice location

7300 Bosque Blvd
Waco, TX 76710-4023

Mailing address

PO Box 848476
Dallas, TX 75284-8476
Phone (254) 202-4655

Other practice location 1

2201 MacArthur Dr Ste 2205
Waco, TX 76708-3159
Phone (254) 202-6500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbullajian44324@direct.sw.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090320000278 TX Practitioner - Nurse Practitioner 9739246653 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hillcrest Family Health CenterGroup PAC ID 4183612278, 62 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

2201 Macarthur Dr
Waco, TX 76708-3161
Phone (254) 202-4360

2201 Macarthur Dr
Suite 100B
Waco, TX 76708-3159
Phone (254) 202-6500

5400 Laurel Lake Dr
Waco, TX 76710-2835
Phone (254) 399-6633

7300 Bosque Blvd
Waco, TX 76710-4023
Phone (254) 202-7700

851 N Loop
340 B S and W H Clinic Bellmead
Waco, TX 76705-2592
Phone (254) 202-7500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
720770TXMDFamily Nurse Practitioner
AP116267TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hillcrest Physician Services CurrentSince Sep 8, 2014 Accepting new patients
Hillcrest Family Health Center CurrentSince Jul 1, 2021 Accepting new patients
Hillcrest Family Health NP Services PLLC Past Accepting new patients

Locations

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

2201 MacArthur Dr
Ste 2205
Waco, TX 76708
Phone (254) 202-6500

3000 Herring Ave
Waco, TX 76708
Phone (254) 202-2000

50 Hillcrest Medical Blvd
Waco, TX 76712
Phone (254) 202-7300

7300 Bosque Blvd
Waco, TX 76710
Phone (254) 202-2600

851 N Loop 340
#B
Waco, TX 76705
Phone (254) 202-7500

Interoperability endpoints

  • Direct secure messaging: kbullajian44324@direct.sw.org

Organizations & group practices 4

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 7

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": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1033306303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848476",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752848476",
            "telephone_number": "254-202-4655",
            "fax_number": "254-202-4697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 BOSQUE BLVD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104023",
            "telephone_number": "254-202-2600",
            "fax_number": "254-202-2650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 MacArthur Dr Ste 2205",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767083159",
            "country_code": "US",
            "telephone_number": "254-202-6500",
            "fax_number": "254-202-6510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLAJIAN",
        "first_name": "KANDACE",
        "middle_name": "MARIE",
        "credential": "RN, MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP116267",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "720770",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbullajian44324@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7300 Bosque Blvd",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767104023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.