Individual provider Active NPI

Kristian A. Ulloa, MD

  • Vascular Surgery Physician
  • Bradenton, FL
National Provider Identifier
1760517775
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME174209 Issued in FL
Practice address
6220 Manatee Ave W Ste 203
Bradenton, FL 34209-2361
Phone
(941) 795-6370
Fax
(941) 798-9977
NPI assigned
Feb 22, 2007
Last updated
Nov 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME174209 FL
Vascular Surgery Physician 2086S0129X ME174209 FL Primary

Addresses

Primary practice location

6220 Manatee Ave W Ste 203
Bradenton, FL 34209-2361

Mailing address

6220 Manatee Ave W Ste 203
Bradenton, FL 34209-2361
Phone (941) 795-6370

Other practice location 1

2020 59th St W
Bradenton, FL 34209-4604
Phone (941) 792-6611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20251223000158 FL Practitioner - Vascular Surgery 6608045752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Rutgers New Jersey Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vascular Wellness Institute, LLC.Group PAC ID 3476048299, 3 clinicians

Practice addresses (Care Compare)

6220 Manatee Ave W
Suite 203
Bradenton, FL 34209-2361
Phone (941) 795-6370

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.84 of 100Reported as group
Quality
73.85
Promoting interoperability
88
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Varicose vein removal18
Leg revascularization (restoring blood flow)38
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME174209FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Wellness Institute, LLC. Vascular Surgery CurrentSince Nov 1, 2025 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2020 59th St W
Bradenton, FL 34209
Phone (813) 798-6303

6220 Manatee Ave W
Ste 203
Bradenton, FL 34209
Phone (941) 795-6370

Interoperability endpoints

  • Direct secure messaging: kristian.ulloa@direct.vsadocs.nextgenshare.com
  • Direct secure messaging: kulloa7696@direct.umm.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1760517775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6220 MANATEE AVE W STE 203",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342092361",
            "telephone_number": "941-795-6370",
            "fax_number": "941-798-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6220 MANATEE AVE W STE 203",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342092361",
            "telephone_number": "941-795-6370",
            "fax_number": "941-798-9977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 59th St W",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342094604",
            "country_code": "US",
            "telephone_number": "941-792-6611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ULLOA",
        "first_name": "KRISTIAN",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME174209",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME174209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.