Olivia Michelle Bullock, DO - Medicare Family Medicine in Saint Johns, FL

  1. Home
  2. Family Medicine
  3. FL
  4. Saint Johns
Olivia Michelle Bullock, DO is a medicare enrolled "Family Medicine" physician in Saint Johns, Florida. Her current practice location is 1310 County Road 210 W, Saint Johns, Florida. You can reach out to her office (for appointments etc.) via phone at (904) 824-4407.

Olivia Michelle Bullock is licensed to practice in Florida (license number OS18963) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114542859.

Contact Information

Olivia Michelle Bullock, DO
1310 County Road 210 W,
Saint Johns, FL 32259
(904) 824-4407
(904) 390-7459

Map and Direction




Physician's Profile

Full NameOlivia Michelle Bullock
GenderFemale
SpecialityFamily Medicine
Location1310 County Road 210 W, Saint Johns, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1114542859
  • Provider Enumeration Date: 06/09/2020
  • Last Update Date: 08/15/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 6709208903
  • Enrollment ID: I20230615000673

Medical Identifiers

Medical identifiers for Olivia Michelle Bullock such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114542859NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine OS18963 (Florida)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. Olivia Michelle Bullock allows following entities to bill medicare on her behalf.
Entity NameBaptist Primary Care Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1508817529
PECOS PAC ID: 0648177733
Enrollment ID: O20031217000248

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. Olivia Michelle 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 AddressPractice Location Address
Olivia Michelle Bullock, DO
Po Box 746638,
Atlanta, GA 30374-6638

Ph: (904) 202-1032		Olivia Michelle Bullock, DO
1310 County Road 210 W,
Saint Johns, FL 32259

Ph: (904) 824-4407

Reviews and Comments


Family Medicine Doctors in Saint Johns, FL

Dr. Matthew Ryan Deboer, DO
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1310 County Road 210 W, Saint Johns, FL 32259
Phone: 904-824-4407    Fax: 904-390-7459
Dr. Ana Maria Romero, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1310 County Road 210 W, Saint Johns, FL 32259
Phone: 904-824-4407    Fax: 904-390-7459
Farid Ahmed, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2001 County Road 210 W Ste 101, Saint Johns, FL 32259
Phone: 904-450-8401    Fax: 904-450-8419
Robert Edward Stapleton, D.O.
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 1310 County Road 210 W, Saint Johns, FL 32259
Phone: 904-824-4407    Fax: 904-390-7459
Tristan A Imhof, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 2570 Race Track Road, Suite A, Saint Johns, FL 32259
Phone: 904-819-1005    Fax: 904-819-1002

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.