Thomas J Bullock, MD

Primary specialty

Epilepsy PhysicianTaxonomy code 2084E0001X

License

1578907671 Issued in WA

Practice address

1135 116TH Ave NE Ste 500
Bellevue, WA 98004-4627

Phone

(801) 699-8936

NPI assigned

Apr 20, 2013

Last updated

Oct 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

EpileptologistsAlso: Neurology

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

King County Public Hospital District No 2Group PAC ID 7618880097, 586 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124
• Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• King County Public Hospital District No 2

  dba Booth Gardner Parkinsons Care Center

  • Neuromusculoskeletal Medicine & OMM Physician
  • Kirkland, WA
  • NPI 1801986070
  Medicare reassignment Care Compare group NPD
• Overlake Medical Clinics, LLC

  • Specialist
  • Bellevue, WA
  • NPI 1801828421
  Medicare reassignment Care Compare group NPD
• King County Public Hospital District No 2

  dba EvergreenHealth Medical Group Pro Fees

  • Internal Medicine Physician
  • Kirkland, WA
  • NPI 1467542639
  NPD
• King County Public Hospital District No. 2

  dba EvergreenHealth at Home Physical Therapy

  • Physical Therapist
  • Kirkland, WA
  • NPI 1356920946
  NPD
• Overlake Medical Clinics LLC

  • Specialist
  • Bellevue, WA
  • NPI 1871745703
  NPD
• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1861432726
  NPD (past)

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

• King County Public Hospital District No. 2

  dba EvergreenHealth Medical Center

  • General Acute Care Hospital
  • Kirkland, WA
  • NPI 1033174933
  Care Compare affiliation
• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1598971855
  Care Compare affiliation
• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1861432726
  Care Compare affiliation

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

{
    "created_epoch": "1366416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1578907671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE STE 500",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044627",
            "telephone_number": "425-635-6560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE STE 500",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044627",
            "telephone_number": "801-699-8936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-20",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "TX",
            "license": "BP10047662",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CO",
            "license": "DR.0058235",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "61345139",
            "primary": false
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "WA",
            "license": "1578907671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000149868",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "028905",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Buitron
• Samyar Stanislav Bukovcan, N.D.
• Madison Louise Bull, RBT
• Anja Kate Bullen
• Julie Lewis Bullock
• Stanley Jon Bunas, MD
• Jacqueline Bunce, DDS,MS
• Alan Bunin, M.D.
• Viviane M Bunin, MD
• Aiden Bunn

• Epilepsy Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Epilepsy Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.