David Payne Bullis, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6826 Issued in MA

Practice address

MGH
55 Fruit Street
Boston, MA 02114

Phone

(617) 219-1279

NPI assigned

Apr 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The General Hospital CorporationGroup PAC ID 6507803806, 1,275 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bullis.david.nwh@direct.partners.masshiway.net

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.

• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Medicare reassignment Care Compare group NPD
• Gateway Consultation & Counseling Services LLC

  • Clinical Psychologist
  • Milton, MA
  • NPI 1528267291
  Medicare reassignment Authorized official
• Mass General Brigham Medical Group Suburban Massachusetts Inc

  • Family Medicine Physician
  • Newton, MA
  • NPI 1538191218
  Medicare reassignment NPD
• Massachusetts General Physicians Organization Inc

  • Dermatology Physician
  • Boston, MA
  • NPI 1801874573
  Medicare reassignment NPD
• Newton Wellesley Hospital

  • General Acute Care Hospital
  • Newton, MA
  • NPI 1952845521
  NPD
• Nova Psychiatric Service

  • Psychologist
  • Quincy, MA
  • NPI 1598838781
  NPD (past)
• Nova Psychiatric Services, PC

  • Community/Behavioral Health Agency
  • Quincy, MA
  • NPI 1881782522
  NPD (past)

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

• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Care Compare affiliation

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1760445977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 AUSTIN ST",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021861104",
            "telephone_number": "617-698-1778",
            "fax_number": "781-843-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MGH",
            "address_2": "55 FRUIT STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-219-1279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Austin St",
            "address_purpose": "LOCATION",
            "city": "Milton",
            "state": "MA",
            "postal_code": "021861104",
            "country_code": "US",
            "telephone_number": "781-843-2555",
            "fax_number": "781-843-9199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLIS",
        "first_name": "DAVID",
        "middle_name": "PAYNE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "6826",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "6826",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0526592",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W10653",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lee Bulgin, M.D.
• Linda A Bulich, MD
• Elizabeth Seairse Bull
• Alexa Bullard, AUD, CCC-A
• Deborah J Bullard, N.P.
• Ramona Bullock-Johnson, MSW, LCSW-A, LCAS
• Andrea J Bullock, M.D.
• Katherine Lynn Bullock, PA
• Letitia Bullock, RN
• Trinika Bullock, RN, MSN, FNP-C

• Clinical Psychologist in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.