Individual provider Active NPI

Asaf Bullkich, OD

  • Optometrist
  • Duluth, GA
National Provider Identifier
1568141679
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003508 Issued in GA
Practice address
11315 Johns Creek Pkwy Ste 300
Duluth, GA 30097-2644
Phone
(678) 737-4824
NPI assigned
Jul 17, 2023
Last updated
Jul 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003508 GA Primary

Addresses

Primary practice location

11315 Johns Creek Pkwy Ste 300
Duluth, GA 30097-2644

Mailing address

370 Landing Entry
Alpharetta, GA 30022-7634

Other practice location 1

1034 Haw Creek Cir Ste 100
Cumming, GA 30041-6513
Phone (678) 737-4616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20230801002781 GA Practitioner - Optometry 5294196648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milan Eye LLCGroup PAC ID 2668519109, 21 clinicians

Practice addresses (Care Compare)

11315 Johns Creek Pkwy
Suite 300
Johns Creek, GA 30097-1517
Phone (678) 381-2020

Merit-based Incentive Payment System (MIPS)

Final score
84.14 of 100Reported as group
Quality
94
Promoting interoperability
71
Improvement activities
40
Cost
77.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003508GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Milan Eye LLC CurrentSince Jul 18, 2023 Accepting new patients
Alpharetta Eye Surgery Center LLC Past Accepting new patients
Buford Eye Surgery Center Past Accepting new patients

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, 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": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1568141679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 LANDING ENTRY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300227634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11315 JOHNS CREEK PKWY STE 300",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300972644",
            "telephone_number": "678-737-4824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1034 Haw Creek Cir Ste 100",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300416513",
            "country_code": "US",
            "telephone_number": "678-737-4616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLKICH",
        "first_name": "ASAF",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.