Individual provider Active NPI

Bianca Emilia Rullan Oliver, M.D.

  • Otolaryngology Physician
  • San Juan, PR
National Provider Identifier
1053780387
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
22528 Issued in PR
Practice address
735 Ave Ponce de Leon Ste 512
San Juan, PR 00917-5027
Phone
(787) 751-1910
Fax
(787) 282-7131
NPI assigned
Sep 16, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD470238 PA
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 22528 PR Primary

Addresses

Primary practice location

735 Ave Ponce de Leon Ste 512
San Juan, PR 00917-5027

Mailing address

735 Ave Ponce de Leon Ste 512
San Juan, PR 00917-5027
Phone (787) 751-1910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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

Enrollment IDStateProvider typePAC IDDetails
I20211202000021 PR Practitioner - Otolaryngology 0840614913 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Ponce School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Rehabilitation Services IncGroup PAC ID 0345406187, shared by 2 NPIs, 51 clinicians

Practice addresses (Care Compare)

Uu43 Calle
Bayamon, PR 00956-4701
Phone (787) 787-8669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD470238PAMDOtolaryngology Physician
22528PRMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rullan Sinus Surgical Center LLC Single Specialty CurrentSince Sep 23, 2021 Accepting new patients
Pedro J Rullan Marin Medical Services, CSP Otolaryngology PastSince Sep 23, 2021 Accepting new patients

Locations

735 Ave Ponce de Leon
Ste 512
San Juan, PR 00917
Phone (787) 751-1910

Organizations & group practices 2

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": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1053780387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 AVE PONCE DE LEON STE 512",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175027",
            "telephone_number": "787-751-1910",
            "fax_number": "787-282-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 AVE PONCE DE LEON STE 512",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175027",
            "telephone_number": "787-751-1910",
            "fax_number": "787-282-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RULLAN OLIVER",
        "first_name": "BIANCA",
        "middle_name": "EMILIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD470238",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "PR",
            "license": "22528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.