Dr Colette Devona Bullock, DO is a medicare enrolled "Internal Medicine" physician in Sugar Hill, Georgia. She went to Philadelphia College Of Osteopathic Medicine and graduated in 2007 and has 17 years of diverse experience with area of expertise as Internal Medicine. Her current practice location is
5422 Cumming Hwy Ste 104, Sugar Hill, Georgia. You can reach out to her office (for appointments etc.) via phone at
(678) 466-9193.
Dr Colette Devona Bullock is licensed to practice in Georgia (license number 75415) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1164612370.
Physician's Profile
| Full Name | Dr Colette Devona Bullock |
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| Gender | Female |
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| Speciality | Internal Medicine |
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| Experience | 17 Years |
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| Location | 5422 Cumming Hwy Ste 104, Sugar Hill, Georgia |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Colette Devona Bullock attended and graduated from Philadelphia College Of Osteopathic Medicine in 2007
NPI Data:
- NPI Number: 1164612370
- Provider Enumeration Date: 07/25/2007
- Last Update Date: 10/08/2022
Medicare PECOS Information:
- PECOS PAC ID: 3375722648
- Enrollment ID: I20160829000772
Medical Identifiers
Medical identifiers for Dr Colette Devona Bullock such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1164612370 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | OS015213 (Pennsylvania) | Secondary |
| 207R00000X | Internal Medicine | 25MB08802400 (New Jersey) | Secondary |
| 207R00000X | Internal Medicine | 75415 (Georgia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Colette Devona Bullock allows following entities to bill medicare on her behalf.
| Entity Name | Legacy Medical, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750846648
PECOS PAC ID: 9739515404
Enrollment ID: O20200129001441 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Colette Devona Bullock is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Colette Devona Bullock, DO
5422 Cumming Hwy Ste 104,
Sugar Hill, GA 30518-7027
Ph: (678) 765-7147 | Dr Colette Devona Bullock, DO
5422 Cumming Hwy Ste 104,
Sugar Hill, GA 30518-7027
Ph: (678) 466-9193 |
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