Individual provider Active NPI

Emily Bulson, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Pinellas Park, FL
National Provider Identifier
1194352708
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
21396 Issued in FL
Practice address
8455 66TH St N
Pinellas Park, FL 33781-1206
Phone
(727) 545-2339
NPI assigned
Mar 24, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 21396 FL Primary

Addresses

Primary practice location

8455 66TH St N
Pinellas Park, FL 33781-1206

Mailing address

8455 66TH St N
Pinellas Park, FL 33781-1206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20241009001116 FL Practitioner - Pathology 9436680865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Pathology Laboratories PAGroup PAC ID 4385785880, 9 clinicians

Practice addresses (Care Compare)

8455 66TH St N
Pinellas Park, FL 33781-1206
Phone (727) 545-0109

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21396FLMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Degregorio MD P a Single Specialty Current Accepting new patients
Surgical Pathology Laboratories PA Single Specialty CurrentSince Sep 24, 2024 Accepting new patients

Locations

8455 66th St N
Pinellas Park, FL 33781
Phone (727) 545-0109

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": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1194352708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8455 66TH ST N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337811206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8455 66TH ST N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337811206",
            "telephone_number": "727-545-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULSON",
        "first_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "21396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinellas Park, FL

Sources for this page

Verify at the official NPI Registry.