MS. LUCILYN ANN BULLOCK PA-C
NPI 1104963552
Physician Assistant - Medical in Tallmadge, OH

Active since February 01, 2007PECOS EnrolledAccepts Medicare Assignment
60 NORTH AVE, TALLMADGE, OH 44278(330) 670-4242(330) 670-4241 Get Directions Write a Review

NPPES record last updated: March 30, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ms. Lucilyn Ann Bullock Pa-c NPPES

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

MS. LUCILYN ANN BULLOCK PA-C (NPI 1104963552) is an individual medical provider in Tallmadge, Ohio, licensed in Ohio (50-000779) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2009).

NPPES Registry Identity

NPI1104963552
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMS. LUCILYN ANN BULLOCKCredential: PA-C
Location Address60 NORTH AVETallmadge, OH 44278-2011
Mailing Address60 North AveTallmadge, OH 44278-2011 · (330) 630-9726 · Fax (330) 634-2194
Fax(330) 670-4241
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateFebruary 1, 2007
Last NPPES UpdateMarch 30, 2022
NPPES CertifiedMarch 30, 2022
NPI 1104963552 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in OH · 50-000779
60 NORTH AVE, Tallmadge, OH 44278

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ms. Lucilyn Ann Bullock Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6507921756
PECOS Enrollment IDI20090223000283
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
31 services29 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
18 services18 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
18 services18 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
4%138 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
37%114 patients2/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
62%154 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
82%170 patients4/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
28%75 patients2/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 7

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

Family Medicine
60 NORTH AVE
TALLMADGE, OH 44278
Physician Assistant
60 NORTH AVE
TALLMADGE, OH 44278
Physician Assistant
60 NORTH AVE
TALLMADGE, OH 44278
Nurse Practitioner (Family)
60 NORTH AVE
TALLMADGE, OH 44278
Orthopaedic Surgery
60 NORTH AVE
TALLMADGE, OH 44278
Family Medicine
60 NORTH AVE
TALLMADGE, OH 44278
Family Medicine
60 NORTH AVE
TALLMADGE, OH 44278

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 Lucilyn Bullock's NPI number?

The NPI number for Lucilyn Bullock is 1104963552. It was assigned to this individual provider in the NPPES registry on February 1, 2007.

Where is Lucilyn Bullock located?

Lucilyn Bullock practices at 60 North Ave, Tallmadge, OH 44278. The listed phone number is (330) 670-4242.

What is Lucilyn Bullock's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Lucilyn Bullock enrolled in Medicare?

Yes. Lucilyn Bullock is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Lucilyn Bullock accept?

Health plans from CareSource and MedMutual list Lucilyn Bullock 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 Lucilyn Bullock was last updated on March 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.