Individual provider Active NPI

Micaiah A Bully, MD

  • Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1255134672
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
3018264 Issued in MA
Practice address
1 Boston Medical Ctr PL Ste 1
Boston, MA 02118-2999
Phone
(617) 638-8000
NPI assigned
Mar 31, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 3018264 MA Primary

Addresses

Primary practice location

1 Boston Medical Ctr PL Ste 1
Boston, MA 02118-2999

Mailing address

1 Boston Medical Ctr PL Ste 1
Boston, MA 02118-2999
Phone (617) 638-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20250811000169 MA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5991203853

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: mbully567545@direct.bilh.masshiway.net

NPI Registry JSON

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

{
    "created_epoch": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1255134672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CTR PL STE 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182999",
            "telephone_number": "617-638-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CTR PL STE 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182999",
            "telephone_number": "617-638-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLY",
        "first_name": "MICAIAH",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-31",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "3018264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.