Ethel C Bullitt, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

228291 Issued in MA

Practice address

1 Brookline PL
Suite 426
Brookline, MA 02445-7224

Phone

(617) 780-6491

NPI assigned

May 30, 2006

Sex

Female

Sole proprietor

No

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 MA

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

Psychiatry

Education

Tufts University School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Youth Opportunities Upheld IncGroup PAC ID 9638190374, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163
• Heywood Hospital - Hospital, Gardner, MA, CCN 220095

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/youinc/r4/

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.

• Youth Opportunities Upheld, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Worcester, MA
  • NPI 1245317205
  Medicare reassignment Care Compare group NPD

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

• Henry Heywood Memorial Hospital

  • General Acute Care Hospital
  • Gardner, MA
  • NPI 1205823879
  Care Compare affiliation
• Heywood Medical Group Inc.

  • General Practice Physician
  • Gardner, MA
  • NPI 1699762286

  Hospital

  Care Compare affiliation
• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1831151455
  Care Compare affiliation

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1700833183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROOKLINE PL",
            "address_2": "SUITE 426",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457224",
            "telephone_number": "617-780-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKLINE PL",
            "address_2": "SUITE 426",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457224",
            "telephone_number": "617-780-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLITT",
        "first_name": "ETHEL",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "228291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Buchwald, P.T.
• Teresa Louise Buck, LICSW
• Guy Jerome Buckle, MD
• Alyse Buckley
• Debra A. Buduo, O.D.
• Martha S Bullock, MSW
• Albert Lee Bundy, M.D.
• Bruce Willard Bunnell, MD
• Caroline Burbank, PMHNP-BC
• Augusta Claire Burhans

• Psychiatry Physician in Brookline, MA
• Providers in Brookline, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.