Individual provider Active NPI

Diane Kaye Bullman

  • Occupational Therapist
  • Greenwood, IN
National Provider Identifier
1790243780
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31002503A Issued in IN
Practice address
402 W Main St
Greenwood, IN 46142-3115
Phone
(317) 408-9069
NPI assigned
Mar 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31002503A IN Primary

Addresses

Primary practice location

402 W Main St
Greenwood, IN 46142-3115

Mailing address

1627 W 75TH PL
Indianapolis, IN 46260-3205
Phone (317) 252-4821

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190614001826 IN Practitioner - Occupational Therapist in Private Practice 1658604103 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy on Wheels IncGroup PAC ID 1557659588, 9 clinicians

Practice addresses (Care Compare)

124 Hawthorne LN
Greenwood, IN 46142-9430

531 Westberry LN
Greenwood, IN 46142-5504
Phone (317) 332-9861

Merit-based Incentive Payment System (MIPS)

Final score
83.79 of 100Reported as group
Quality
90
Improvement activities
40
Cost
30.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31002503AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy on Wheels, Inc. CurrentSince Jun 6, 2019 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1552003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552003200000",
    "number": "1790243780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 W 75TH PL",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462603205",
            "telephone_number": "317-252-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W MAIN ST",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461423115",
            "telephone_number": "317-408-9069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLMAN",
        "first_name": "DIANE",
        "middle_name": "KAYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-08",
        "last_updated": "2019-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31002503A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.