Mark Jeffrey Bullock, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

5901002436 Issued in MI

Practice address

5483 Gratiot Rd
Saginaw, MI 48638-6037

Phone

(989) 583-5626

Fax

(989) 583-1837

NPI assigned

Jun 20, 2012

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Temple University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Medical Center, Inc.Group PAC ID 2769387778, 488 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Covenant at Home Home health agency, Saginaw, MI, CCN 237431
• Covenant Medical Center Hospital, Saginaw, MI, CCN 230070

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbullock45654@direct.covenanthealthcare.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.

• Covenant Medical Center, Inc.

  • Emergency Medicine Physician
  • Saginaw, MI
  • NPI 1972590412
  Medicare reassignment Care Compare group NPD
• Covenant Medical Center, Inc

  • Family Medicine Physician
  • Saginaw, MI
  • NPI 1619412376
  NPD

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

• Covenant Medical Center, Inc.

  • General Acute Care Hospital
  • Saginaw, MI
  • NPI 1588656946
  Care Compare affiliation
• Visiting Nurse Association of Saginaw

  • Home Health Agency
  • Saginaw, MI
  • NPI 1073595245
  Care Compare affiliation

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1134482532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 NORTH HARRISON",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "48602",
            "telephone_number": "989-799-5557",
            "fax_number": "989-799-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5483 GRATIOT RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486386037",
            "telephone_number": "989-583-5626",
            "fax_number": "989-583-1837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Cooper Ave",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486025383",
            "country_code": "US",
            "telephone_number": "989-583-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "MARK",
        "middle_name": "JEFFREY",
        "name_prefix": "Mr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901002436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbullock45654@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "5483 Gratiot Rd",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486386037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brandon Buffman
• Marcus Buford
• Gregory Bujouves
• Imani Bulger
• Jaylon Bullock
• Aditya D. Bulusu, MD
• Usha Kurumety Bulusu, M.D.
• Stacey Lynn Bump, LMSW
• Joanna Bundy
• Michael Bunkley

• Foot & Ankle Surgery Podiatrist in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Foot & Ankle Surgery Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.