Individual provider Active NPI

Kathryn L Bulgrin, DO

  • Emergency Medicine Physician
  • Warren, OH
National Provider Identifier
1477539963
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
34007723B Issued in OH
Practice address
667 Eastland Ave SE
Warren, OH 44484-4503
Phone
(330) 841-4000
Fax
(330) 841-4007
NPI assigned
Dec 16, 2005
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
Emergency Medicine Physician 207P00000X 34007723B OH Primary

Addresses

Primary practice location

667 Eastland Ave SE
Warren, OH 44484-4503

Mailing address

5700 Darrow Rd
Suite 106
Hudson, OH 44236-5021
Phone (330) 656-5911

Other identifiers 1

IdentifierTypeStateIssuer
2388616MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20031202000121 OH Practitioner - Emergency Medicine 9638074875 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Ohio University, College of Osteopathic Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allen Emergency Physicians LLCGroup PAC ID 9739554379, 13 clinicians

Practice addresses (Care Compare)

200 W Lorain St
Oberlin, OH 44074-1026
Phone (440) 775-1211

Hospital & facility affiliations

  • Mercy Allen Hospital Hospital, Oberlin, OH, CCN 361306

Merit-based Incentive Payment System (MIPS)

Final score
86.62 of 100Reported as group
Quality
71.63
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34007723BOHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lorain Emergency Physicians, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Allen Emergency Physicians, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
4M Emergency Systems LLC Emergency Medicine Past Accepting new patients

Locations

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

200 W Lorain St
Oberlin, OH 44074
Phone (440) 775-1211

Organizations & group practices 3

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477539963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 DARROW RD",
            "address_2": "SUITE 106",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442365021",
            "telephone_number": "330-656-5911",
            "fax_number": "330-656-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 EASTLAND AVE SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444844503",
            "telephone_number": "330-841-4000",
            "fax_number": "330-841-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULGRIN",
        "first_name": "KATHRYN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34007723B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2388616",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.