Timothy C Bullard, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A64738 Issued in CA

Practice address

4560 Admiralty Way Ste 100
Marina del Rey, CA 90292-5424

Phone

(108) 273-7003

NPI assigned

Apr 19, 2006

Last updated

Oct 7, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CA, IN2 enrollments

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 2

Specialty

Emergency MedicineAlso: Family Practice

Education

Indiana University School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Regents of the University of CaliforniaGroup PAC ID 1355248584, 1,426 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112

Merit-based Incentive Payment System (MIPS)

Final score

87.51 of 100Reported as group

Quality

79.37

Promoting interoperability

100

Improvement activities

40

Cost

73.65

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tbullard@yourcarecommunity.org
• Direct secure messaging: tbullard765573@direct.uclahealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Regents of the University of California

  dba UCLA Dept of Medicine

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1235107566

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment NPD
• Regents of the University of California

  dba UCLA Entertainment Ind MedGrp

  • Internal Medicine Physician
  • Glendale, CA
  • NPI 1891110888

  Family Medicine

  Medicare reassignment NPD
• North Indiana Emergency Physicians, LLP

  • Emergency Medicine Physician
  • La Porte, IN
  • NPI 1144691478
  Medicare reassignment NPD
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Hanford, CA
  • NPI 1508938465
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Regents of the University of California

  dba UCLA Entertainment Ind Medgrp

  • Durable Medical Equipment & Medical Supplies
  • Woodland Hills, CA
  • NPI 1083063127
  NPD
• The Regents of the University of California

  dba UCLA Dept of Medicine

  • Ambulatory Surgical Clinic/Center
  • Valencia, CA
  • NPI 1689200305
  NPD
• Beacon Kalamazoo Inc

  dba Beacon Kalamazoo

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1568416311
  NPD
• Gaylene J. Soloniuk-Tays, M.D., a Professional Corporation

  dba Compassionate Family Care

  • Family Medicine Physician
  • Visalia, CA
  • NPI 1023184546
  NPD (past)
• Artesian Waters Emergency Physicians

  • Emergency Medicine Physician
  • Martinsville, IN
  • NPI 1639312028
  NPD (past)
• Beacon Dowagiac Inc

  dba Beacon Dowagiac

  • Critical Access Hospital
  • Dowagiac, MI
  • NPI 1194771030
  NPD (past)

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

• Regents of the Univ of California

  dba Santa MonicaUCLAMC and Orthopedic Hospital

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1427055839
  Care Compare affiliation

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1306801766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY STE 100",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925424",
            "telephone_number": "108-273-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "TIMOTHY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A64738",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01051619",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301082809",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A64738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS MI",
            "identifier": "1306801766",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306801766",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "930098046",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A647380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Bonnie Brumer, LCSW
• Barbara Bruton, M.D.
• April Buckins, DDS
• Building Block Resolutions
• Andrzej Bulczynski, MEDICAL DOCTOR
• Tygr Lynne Burnett, DPT
• Aaron Burrola
• C.W. Klishevich
• California Coastal Care
• California Counseling Center

• Family Medicine Physician in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.