Individual provider Active NPI

Deborah J Bullard, N.P.

  • Adult Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1700974854
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
210635 Issued in MA
Practice address
55 Fruit Street
MGH Clinics 115
Boston, MA 02114
Phone
(617) 726-3800
NPI assigned
Oct 11, 2006
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
Adult Health Nurse Practitioner 363LA2200X 210635 MA Primary

Addresses

Primary practice location

55 Fruit Street
MGH Clinics 115
Boston, MA 02114

Mailing address

55 Fruit Street
MGH Clinics 115
Boston, MA 02114
Phone (617) 726-3800

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040909000508 MA Practitioner - Nurse Practitioner 1557337615 Reassigns benefits to 2 organizations
Practice locations: Danvers, MA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
210635MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Lahey Inpatient Specialists PLLC CurrentSince Jun 1, 2020 Accepting new patients
Lowell General Inpatient Specialists PLLC CurrentSince May 1, 2020 Accepting new patients
Winchester Hospital Inpatient Specialists PLLC Past Accepting new patients
Elliot Professional Services PastSince Mar 25, 2013 Accepting new patients
Boston Emergency Physician Foundation, Inc. Past Accepting new patients
Boston Medical Center Past Accepting new patients
Elliot Professional Services Past Accepting new patients

Locations

290 Littleton Rd
Unit 3
Chelmsford, MA 01824
Phone (978) 258-4734

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

41 Highland Ave
Winchester, MA 01890
Phone (781) 756-2000

1 Harbison Way
Ste 222
Columbia, SC 29212

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700974854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT STREET",
            "address_2": "MGH CLINICS 115",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT STREET",
            "address_2": "MGH CLINICS 115",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD",
        "first_name": "DEBORAH",
        "middle_name": "J",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "210635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.