Individual provider Active NPI

Andrew G. Bullock, MD

  • Cardiovascular Disease Physician
  • Los Angeles, CA
National Provider Identifier
1124552641
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A197442 Issued in CA
Practice address
8631 W 3Rd St Ste 635E
Los Angeles, CA 90048-5994
Phone
(310) 248-8245
NPI assigned
Apr 12, 2017
Last updated
Sep 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 68932 TN
Cardiovascular Disease Physician 207RC0000X 11751223-1205 UT
Cardiovascular Disease Physician 207RC0000X A197442 CA Primary

Addresses

Primary practice location

8631 W 3Rd St Ste 635E
Los Angeles, CA 90048-5994

Mailing address

3841 Green Hills Village Dr
Nashville, TN 37215-2691

Other practice location 1

30 N 1900 E Rm 4A100
Salt Lake City, UT 84132-0002
Phone (801) 585-7676

Other practice location 2

3601 The Vanderbilt Clinic
Nashville, TN 37232-0002
Phone (615) 322-3000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address abullock19529@direct.vumc.org Direct
Direct Messaging Address gbullock439890@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240823000531 CA Practitioner - Cardiovascular Disease (Cardiology) 2668896226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Pittsburgh School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

8631 W 3Rd St
Suite 510
Los Angeles, CA 90048-5909
Phone (310) 385-3380

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68932TNMDInternal Medicine Physician
A197442CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Aug 6, 2024 Accepting new patients

Locations

8631 W 3rd St
Ste 510
Los Angeles, CA 90048
Phone (310) 278-1490

8631 W 3rd St
Ste 635E
Los Angeles, CA 90048
Phone (310) 248-8245

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

Interoperability endpoints

  • Direct secure messaging: abullock19529@direct.vumc.org
  • Direct secure messaging: abullock504180@direct.cshs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1124552641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST STE 635E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485994",
            "telephone_number": "310-248-8245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 N 1900 E Rm 4A100",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841320002",
            "country_code": "US",
            "telephone_number": "801-585-7676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 The Vanderbilt Clinic",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372320002",
            "country_code": "US",
            "telephone_number": "615-322-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "ANDREW",
        "middle_name": "G.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-12",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "68932",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "UT",
            "license": "11751223-1205",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A197442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abullock19529@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372320002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gbullock439890@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.