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KYLIE MICHELLE BULL CCC-SLP
NPI 1063935815
Speech-Language Pathologist in Boise, ID

Active since July 24, 2017
1409 W MAIN ST STE 120, BOISE, ID 83702(208) 370-5857(208) 506-6312 Get Directions Write a Review

NPPES record last updated: May 17, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 17, 2023, Jul 21, 2022, Mar 17, 2018 and 1 more (4 updates tracked since 2017).

About Kylie Michelle Bull Ccc-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KYLIE MICHELLE BULL CCC-SLP (NPI 1063935815) is an individual speech-language pathologist provider in Boise, Idaho, licensed in Idaho (TSLP-3247) and active in the NPI registry since July 2017. She maintains 2 additional practice locations.

NPPES Registry Identity

NPI1063935815
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameKYLIE MICHELLE BULLCredential: CCC-SLP
Location Address1409 W MAIN ST STE 120Boise, ID 83702-5215
Mailing Address935 E Winding Creek Dr Ste 120Eagle, ID 83616-7242 · (208) 938-4748
Phone(208) 370-5857
Fax(208) 506-6312
Sole ProprietorNo
Enumeration DateJuly 24, 2017
Last NPPES UpdateMay 17, 20234 updates tracked since enumeration
NPPES CertifiedMay 17, 2023
✔ NPI 1063935815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in ID · TSLP-3247
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
1409 W MAIN ST STE 120, Boise, ID 83702
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Secondary Practice Locations 2

Location 1935 E Winding Creek Dr Ste 120Eagle, ID 83616-7242 · Phone (208) 938-4748
Location 2964 W Idaho AveOntario, OR 97914-2111 · Phone (208) 938-4748

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kylie Michelle Bull Ccc-slp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Kylie Bull reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Boise Speech Tree, LLC
0.5 mi
Speech-Language Pathologist
1015 W HAYS ST STE 104
Boise, ID 83702
  • Reassigned Medicare billing, Idaho enrollment
  • 6 clinicians in this Medicare group
NPI 1689168445 (208) 938-4748

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. WAVEY LOUISE TUCK LCSW
Social Worker (Clinical)
1409 W MAIN ST STE 120
BOISE, ID 83702
Ada County (406) 480-5800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kylie Bull's NPI number?

The NPI number for Kylie Bull is 1063935815. It was assigned to this individual provider in the NPPES registry on July 24, 2017.

Where is Kylie Bull located?

Kylie Bull practices at 1409 W Main St Ste 120, Boise, ID 83702. The listed phone number is (208) 370-5857.

What is Kylie Bull's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Kylie Bull enrolled in Medicare?

Yes. Kylie Bull is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kylie Bull's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kylie Bull reassigns Medicare benefits to Boise Speech Tree, LLC (Boise, ID). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kylie Bull's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kylie Bull accept?

Health plans from Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Select Health list Kylie Bull as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kylie Bull was last updated on May 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.