Cody Bulgarelli, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

58569 Issued in CA

Practice address

11818 Southfork View CT
Weldon, CA 93283-9509

Phone

(760) 223-2456

NPI assigned

Jun 28, 2020

Last updated

Sep 30, 2020By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kern Valley Healthcare DistrictGroup PAC ID 8628069689, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kern Valley Healthcare District Hospital, Lake Isabella, CA, CCN 051314

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Kern Valley Healthcare District

  • Critical Access Hospital
  • Lake Isabella, CA
  • NPI 1427049964
  Medicare reassignment Care Compare group
• Kern Valley Healthcare District

  dba Mountain View Health Clinic

  • Rural Health Clinic/Center
  • Mt Mesa, CA
  • NPI 1457854192
  NPD
• Kern Valley Healthcare District

  dba Kern Valley Healthcare District MobileCare

  • Rural Health Clinic/Center
  • Lake Isabella, CA
  • NPI 1588129027
  NPD (past)

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

• Kern Valley Healthcare District

  • Critical Access Hospital
  • Lake Isabella, CA
  • NPI 1427049964
  Care Compare affiliation

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

{
    "created_epoch": "1593302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1437776283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "KERNVILLE",
            "state": "CA",
            "postal_code": "932380308",
            "telephone_number": "760-223-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11818 SOUTHFORK VIEW CT",
            "city": "WELDON",
            "state": "CA",
            "postal_code": "932839509",
            "telephone_number": "760-223-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULGARELLI",
        "first_name": "CODY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-28",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Silvio Conner, MSW, PPSC
• Ladonna Kay Jaujou, MA PPS
• Jessica Marie Kennedy, RN
• Jackelyn Nicole Ray, RN, BSN
• South Fork Union School District

• Physician Assistant in Weldon, CA
• Providers in Weldon, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.