Individual provider Active NPI

Annette M Bulas, OD

  • Optometrist
  • Orchard Park, NY
National Provider Identifier
1326102286
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV5250 Issued in NY
Practice address
3151 Southwestern Blvd
Orchard Park, NY 14127-1212
Phone
(716) 674-6030
Fax
(716) 674-6052
NPI assigned
Dec 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV5250 NY Primary

Addresses

Primary practice location

3151 Southwestern Blvd
Orchard Park, NY 14127-1212

Mailing address

3151 Southwestern Blvd
Orchard Park, NY 14127-1212
Phone (716) 674-6030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111026000183 NY Practitioner - Optometry 5294858007 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.24 of 100Reported as group
Quality
94.45
Improvement activities
40
Cost
81.53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV5250NYMDOptometrist
005250NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Southtowns Ophthalmology PC CurrentSince Jul 15, 2017 Accepting new patients

Locations

3151 Southwestern Blvd
Orchard Park, NY 14127
Phone (716) 674-6030

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326102286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 SOUTHWESTERN BLVD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271212",
            "telephone_number": "716-674-6030",
            "fax_number": "716-674-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 SOUTHWESTERN BLVD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271212",
            "telephone_number": "716-674-6030",
            "fax_number": "716-674-6052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULAS",
        "first_name": "ANNETTE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV5250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.