Individual provider Active NPI

Theresa N Bullen, M.D.

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1861629388
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD444931 Issued in PA
Practice address
3401 N Broad St
Philadelphia, PA 19140-5103
Phone
(215) 707-2000
NPI assigned
Jun 11, 2009
Last updated
Jan 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD444931 PA Primary

Addresses

Primary practice location

3401 N Broad St
Philadelphia, PA 19140-5103

Mailing address

3500 N Broad St RM 1a
Philadelphia, PA 19140-4106
Phone (215) 707-2433

Other names 1

  • Theresa Pagano Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120928000309 NJ Practitioner - Emergency Medicine 3870742273 Reassigns benefits to 1 organization
I20250421001122 PA Practitioner - Emergency Medicine 3870742273 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Temple University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line Emergency Med Associates LLCGroup PAC ID 9234034729, 51 clinicians
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450
Phone (484) 337-3583

8835 Germantown Ave
Phila, PA 19118-2718
Phone (215) 707-2098

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Associates of South Jersey P C Emergency Medicine CurrentSince Jul 24, 2012 Accepting new patients
Main Line Emergency Med Associates LLC Emergency Medicine CurrentSince Jan 26, 2025 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Dec 8, 2025 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Dec 8, 2025 Accepting new patients
Bayfront Emergency Physicians PA Emergency Medicine Past Accepting new patients

Locations

56 W Main St
Ste 203
Christiana, DE 19702

56 W Main St
Ste 305
Christiana, DE 19702

100 Townsend Ave
Berlin, NJ 08009
Phone (856) 322-3000

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3500 N Broad St
Rm 1A
Philadelphia, PA 19140
Phone (215) 707-2433

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Organizations & group practices 6

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 2

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": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1861629388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N BROAD ST RM 1A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404106",
            "telephone_number": "215-707-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLEN",
        "first_name": "THERESA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-11",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD444931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "PAGANO",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.