Elizabeth Aguanta Bulatao, FNP
Individual provider Active NPI Adult Health Nurse Practitioner · Darien, GA
NPI 1992888754 · NPPES record last updated Aug 19, 2026
Key facts
- NPI
- 1992888754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- RN137184 (GA)
- Practice address
- 5873 US Highway 17
Darien, GA 31305-4062 - Phone
- (912) 450-9750
- Fax
- (833) 468-5564
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cooperative Healthcare Services Inc
Practice addresses (Care Compare)
2415 Parkwood Dr
Brunswick, GA 31520-4722
Phone (912) 466-4079
3222 Shrine Rd a
Brunswick, GA 31520-4357
Phone (912) 264-6303
Hospital & facility affiliations
- Southeast Georgia Health System- Brunswick Campus
Merit-based Incentive Payment System (MIPS)
- Final score
- 76.36 of 100
- Quality
- 46.72
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 75.31
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070517000311 | GA | Practitioner - Nurse Practitioner | 5395842876 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN137184 | GA | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cooperative Healthcare Services Inc | Current |
Accepting new patients | |
| Mary Lee Carter, MD-PC | Past | Accepting new patients |
Locations
3226 Hampton Ave
Ste C
Brunswick, GA 31520
Phone (912) 261-0044
3222 Shrine Rd
Ste A
Brunswick, GA 31520
Phone (912) 264-6303
2500 Starling St
Ste 401
Brunswick, GA 31520
Phone (912) 554-0544
2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079
1111 Glynco Pkwy
Ste 400
Brunswick, GA 31525
Phone (912) 265-1357
308 Bedell Ave
Woodbine, GA 31569
Phone (912) 576-5506
Interoperability endpoints
- ebulat2@secure.sghsmessaging.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | RN137184 | GA | Yes |
Addresses
Primary practice location
5873 US Highway 17
Darien, GA 31305-4062
Mailing address
5873 US Highway 17
Darien, GA 31305-4062
Phone (912) 450-9750
Other providers in Darien, GA
- Agape Prescriptions R US
- Onie Alexander
- Natalie Amerson
- Thomas Brandeberry
- Lee Brandt
- R Jackson Carter
- Coastal Community Health Services, Inc.
- Coastal Community Health Services, Inc.
- Katie C Daniels
- Darien Primary Care Inc
All providers in Darien, GA · Adult Health Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.