Paul V Bullis, MD
Individual provider Active NPI Family Medicine Physician · Hartford, WI
NPI 1184633869 · NPPES record last updated Nov 29, 2021
Key facts
- NPI
- 1184633869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 41040 (WI)
- Practice address
- 1640 E Sumner St
Hartford, WI 53027 - Phone
- (262) 670-4000
- Fax
- (262) 670-4451
- NPI assigned
- Aug 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 25
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Wisconsin School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aurora Advanced Healthcare, Inc.
Practice addresses (Care Compare)
1640 E Sumner St
Hartford, WI 53027-2684
Phone (262) 670-4000
Hospital & facility affiliations
- Aurora at Home
- Lily Hospice
- Aurora Medical Ctr Washington County
- Aurora Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051010000812 | WI | Practitioner - Family Practice |
8325063290 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41040 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Advanced Healthcare, Inc. | Family Medicine | Current |
Accepting new patients |
| Aurora Advanced Healthcare Inc | Current |
Accepting new patients | |
| Seasons Hospice & Palliative Care of Wisconsin, LLC | Family Medicine | Current |
Accepting new patients |
| Aurora Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Aurora Medical Group, Inc. | Current |
Accepting new patients |
Locations
6400 Shafer Ct
Ste 700
Rosemont, IL 60018
3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100
2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200
1004 E Sumner St
Hartford, WI 53027
Phone (262) 670-7000
1032 E Sumner St
Hartford, WI 53027
Phone (262) 670-4300
1640 E Sumner St
Hartford, WI 53027
Phone (262) 670-4000
N8210 State Road 28
Mayville, WI 53050
Phone (920) 387-9175
12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200
3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
6737 W Washington St
Ste 2150
West Allis, WI 53214
Phone (414) 203-8310
205 Valley Ave
West Bend, WI 53095
Phone (262) 338-1123
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Family Medicine) Physician | 207QH0002X | 41040 | WI | |
| Family Medicine Physician | 207Q00000X | 41040 | WI | Yes |
Addresses
Primary practice location
1640 E Sumner St
Hartford, WI 53027
Mailing address
3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32557200 | Medicaid | WI | |
| P00941428 | Other | WY | RR MEDICARE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pbullis13372@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Other providers in Hartford, WI
- Greta Raye Braun
- Joseph J Brenner
- Samantha Brovelli
- Victoria Marie Brown
- Jennifer May Bryant
- Patricia K Burmeister
- Rachel Elizabeth Burtka
- Dorothy J Carl
- Lauren Margaret Carlson
- Elizabeth Augusta Carroll
All providers in Hartford, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.