Miss Misty Star Bullock, - Medicare Occupational Therapist in Philadelphia, PA

Miss Misty Star Bullock, is a medicare enrolled "Occupational Therapist" provider in Philadelphia, Pennsylvania. Her current practice location is 2032 S Frazier St, Philadelphia, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (267) 736-9099.

Miss Misty Star Bullock is licensed to practice in Pennsylvania (license number OC009582) 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 1639354335.

Contact Information

Miss Misty Star Bullock,
2032 S Frazier St,
Philadelphia, PA 19143-5618
(267) 736-9099
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameMiss Misty Star Bullock
GenderFemale
SpecialityOccupational Therapist
Location2032 S Frazier St, Philadelphia, Pennsylvania
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1639354335
  • Provider Enumeration Date: 01/01/2008
  • Last Update Date: 01/01/2008
  Medicare PECOS Information:
  • PECOS PAC ID: 8325121338
  • Enrollment ID: I20080214000259

Medical Identifiers

Medical identifiers for Miss Misty Star Bullock such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1639354335NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225X00000XOccupational Therapist OC009582 (Pennsylvania)Primary
225X00000XOccupational Therapist OT11929 (Florida)Secondary

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. Miss Misty Star Bullock allows following entities to bill medicare on her behalf.
Provider NameFunctional Pathways Preferred Of Tennessee Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1841561446
PECOS PAC ID: 2860649654
Enrollment ID: O20140903000068
Provider NameCortlyn Therapy Pc
Provider TypePart B Supplier - Physical/occupational Therapy Group In Private Practice
Provider IdentifiersNPI Number: 1235725730
PECOS PAC ID: 8729495684
Enrollment ID: O20220207001776

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. Miss Misty Star 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
Miss Misty Star Bullock,
2032 S Frazier St,
Philadelphia, PA 19143-5618

Ph: (267) 736-9099
Miss Misty Star Bullock,
2032 S Frazier St,
Philadelphia, PA 19143-5618

Ph: (267) 736-9099

Reviews and Comments


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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.