Kelsey Bullock

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A148182 Issued in CA

Practice address

11234 Anderson St
Loma Linda, CA 92354

Phone

(909) 558-9532

NPI assigned

May 11, 2015

Last updated

Aug 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Merit-based Incentive Payment System (MIPS)

Final score

88.87 of 100Reported as group

Quality

72.13

Promoting interoperability

80

Improvement activities

40

Cost

77.36

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Department of State Hospitals

  dba Coalinga State Hospital

  • Psychiatric Hospital
  • Coalinga, CA
  • NPI 1124078704
  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment NPD
• Department of State Hospitals

  dba Department of State Hospitals - Patton

  • Psychiatric Hospital
  • Patton, CA
  • NPI 1043249204
  NPD
• Department of State Hospitals

  dba Department of State Hospitals-Atascadero

  • Psychiatric Hospital
  • Atascadero, CA
  • NPI 1174573802
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Psychiatry Physician
  • Redlands, CA
  • NPI 1558311373
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1558788331
  NPD

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1972981926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "GME OFFICE WESTERLY SUITE C",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354",
            "telephone_number": "909-558-9532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354",
            "telephone_number": "909-558-9532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A148182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Edward Bui
• Thucan Timothy Bui, DO
• Tony Bui, RN
• Joshua Macpherson Buley, PSY.D.
• Beryl Heather Bull, MD
• Diane E. Bunker
• William Bunnell, M.D.
• Constanza Burciaga Calderoni, M.D.
• Thomas Burgdorff, M.D.
• Victoria Jade Burghart, MD

• Psychiatry Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.