Shawn Bullock, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A62757 Issued in CA

Practice address

27401 Los Altos
Suite 180
Mission Viejo, CA 92691-6316

Phone

(949) 582-9624

Fax

(949) 582-9626

NPI assigned

Jun 3, 2006

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 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

Specialty

Anesthesiology

Education

University of California, San Francisco School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western Anesthesia Medical Associates Inc 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Western Anesthesia Medical Associates Inc

  • Anesthesiology Physician
  • Mission Viejo, CA
  • NPI 1497796320

  Anesthesiology, CA

  Medicare reassignment Care Compare group NPD

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

• Mission Hospital Regional Medical Center

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1912108002

  Hospital

  Care Compare affiliation
• Mission Hospital Regional Medical Center

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1992752315

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201219200000",
    "number": "1164460978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27401 LOS ALTOS",
            "address_2": "SUITE 180",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916316",
            "telephone_number": "949-582-9624",
            "fax_number": "949-582-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27401 LOS ALTOS",
            "address_2": "SUITE 180",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916316",
            "telephone_number": "949-582-9624",
            "fax_number": "949-582-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "SHAWN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2008-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A62757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A627570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonnie S Bueso
• Amy Thu Bui, M.D.
• Gene Phuoc Huu Bui
• Karen Buist-Baker, RN, CCM,BS, MCG, LNC
• Diana Marie Bull, M.A.
• Rachel Bunetta
• Connor Thomas Bunting, AU.D.
• Michael D Burdi, MD
• Mark Burkhardt, MD
• Nicholas Bond Burley, DO

• All providers in Mission Viejo, CA
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; 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.