Individual provider Active NPI

Wolodymyr Iwan Bula, MD

  • Diagnostic Radiology Physician
  • Plattsburgh, NY
National Provider Identifier
1497712541
Registry record updated Oct 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
196601 Issued in NY
Practice address
16 Degrandpre Way Ste 600
Plattsburgh, NY 12901-6454
Phone
(518) 563-0490
Fax
(518) 563-0707
NPI assigned
May 1, 2006
Last updated
Oct 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 196601 NY Primary

Addresses

Primary practice location

16 Degrandpre Way Ste 600
Plattsburgh, NY 12901-6454

Mailing address

PO Box 2007
East Syracuse, NY 13057-4507
Phone (315) 362-5285

Other identifiers 1

IdentifierTypeStateIssuer
01505384MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VT2 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

Enrollment IDStateProvider typePAC IDDetails
I20060208000766 NY Practitioner - Diagnostic Radiology 8921012303 Reassigns benefits to 7 organizations
I20250106000629 VT Practitioner - Diagnostic Radiology 8921012303 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Vermont College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alice Hyde Medical CenterGroup PAC ID 4082525837, 88 clinicians
Elizabethtown Community HospitalGroup PAC ID 3577554138, shared by 3 NPIs, 62 clinicians

Practice addresses (Care Compare)

133 Park St
Malone, NY 12953-1243
Phone (518) 481-2545

75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 561-2000

75 Park St
Elizabethtown, NY 12932-2300
Phone (518) 673-6377

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Vermont Medical Center Inc CurrentSince Dec 2, 2024 Accepting new patients
Elizabethtown Community Hospital CurrentSince May 1, 2024 Accepting new patients
Alice Hyde Medical Center Current Accepting new patients
Champlain Valley Physicians Hospital Medical Center CurrentSince May 1, 2024 Accepting new patients
Porter Hospital, Inc CurrentSince Dec 2, 2024 Accepting new patients
Afterhours Imaging, LLC Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Alice Hyde Medical Center CurrentSince May 1, 2024 Accepting new patients
University of Vermont Medical Center Inc CurrentSince Dec 2, 2024 Accepting new patients
Porter Hospital Inc Current Accepting new patients
Elizabethtown Community Hospital Current Accepting new patients
Alice Hyde Medical Center Past Accepting new patients

Locations

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

16 Degrandpre Way
Ste 600
Plattsburgh, NY 12901
Phone (518) 562-7500

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

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

104 Porter Dr
Middlebury, VT 05753
Phone (802) 388-5682

115 Porter Dr
Middlebury, VT 05753
Phone (802) 388-4701

82 Catamount Park
Middlebury, VT 05753
Phone (802) 388-7185

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/elizabe-e663f886
  • Direct secure messaging: wbula418354@direct.uvmhealth.org

Organizations & group practices 11

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.

Hospital & facility affiliations 7

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1497712541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2007",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130574507",
            "telephone_number": "315-362-5285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 DEGRANDPRE WAY STE 600",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129016454",
            "telephone_number": "518-563-0490",
            "fax_number": "518-563-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULA",
        "first_name": "WOLODYMYR",
        "middle_name": "IWAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-10-18",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "196601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01505384",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.