NPIMap

Individual provider Active NPI

Daniel P Bullock, MD

  • Orthopaedic Surgery Physician
  • Lake Placid, NY
National Provider Identifier
1366544017
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
252452 Issued in NY
Practice address
203 Old Military Rd
Lake Placid, NY 12946-1738
Phone
(518) 523-1327
Fax
(518) 523-9964
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 46697 CO
Orthopaedic Surgery Physician 207X00000X 252452 NY Primary

Addresses

Primary practice location

203 Old Military Rd
Lake Placid, NY 12946-1738

Mailing address

203 Old Military Rd
Lake Placid, NY 12946-1738
Phone (518) 523-1327

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090610000460 NY Practitioner - Orthopedic Surgery 6002966249 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46697COMDOrthopaedic Surgery Physician
252452NYMDMammography Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Adirondack Medical Center CurrentSince Oct 19, 2023 Accepting new patients
Champlain Valley Physicians Hospital Medical Center CurrentSince Apr 1, 2020 Accepting new patients
Adirondack Medical Center Orthopaedic Surgery CurrentSince Oct 19, 2023 Accepting new patients
Adirondack Medical Center Past Accepting new patients

Locations

29 Church St
Lake Placid, NY 12946
Phone (518) 523-1122

203 Old Military Rd
Lake Placid, NY 12946
Phone (518) 523-1327

75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100

2233 State Route 86
Saranac Lake, NY 12983
Phone (518) 891-4141

Interoperability endpoints

  • Direct secure messaging: dbullock471458@direct.uvmhealth.org

Organizations & group practices 10

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.

Hospital & facility affiliations 6

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

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Geisel School of Medicine at Dartmouth, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adirondack Medical Center 85 clinicians

Practice addresses (Care Compare)

203 Old Military Rd
Lake Placid, NY 12946-1738
Phone (518) 523-1327

Hospital & facility affiliations

  • Adirondack Medical Center - Saranac Lake Hospital, Saranac Lake, NY, CCN 330079
  • The University of Vermont Health Network - Champl Hospital, Plattsburgh, NY, CCN 330250
  • Canton-Potsdam Hospital Hospital, Potsdam, NY, CCN 330197
  • The University of Vermont Health Network-Alice Hy Hospital, Malone, NY, CCN 331321
  • Carthage Area Hospital, Inc Hospital, Ogdensburg, NY, CCN 331324

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement20
Knee replacement28
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)34
Removal of tissue1-10

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1366544017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 OLD MILITARY RD",
            "city": "LAKE PLACID",
            "state": "NY",
            "postal_code": "129461738",
            "telephone_number": "518-523-1327",
            "fax_number": "518-523-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 OLD MILITARY RD",
            "city": "LAKE PLACID",
            "state": "NY",
            "postal_code": "129461738",
            "telephone_number": "518-523-1327",
            "fax_number": "518-523-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "DANIEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CO",
            "license": "46697",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "252452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Placid, NY

Sources for this page

Verify at the official NPI Registry.