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OLIVIA MICHELLE BULLOCK DO
NPI 1114542859
Family Medicine in Saint Johns, FL

Active since June 09, 2020PECOS EnrolledAccepts Medicare Assignment
91.62/100
CMS Quality Rating
1310 COUNTY ROAD 210 W, SAINT JOHNS, FL 32259(904) 824-4407(904) 390-7459 Get Directions Write a Review

NPPES record last updated: August 15, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 15, 2023, Jun 9, 2023, Jun 9, 2020 (3 updates tracked since 2020).

About Olivia Michelle Bullock Do NPPES

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

OLIVIA MICHELLE BULLOCK DO (NPI 1114542859) is an individual family medicine provider in Saint Johns, Florida, licensed in Florida (OS18963) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and maintains a secondary practice location in Jacksonville.

NPPES Registry Identity

NPI1114542859
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameOLIVIA MICHELLE BULLOCKCredential: DO
Location Address1310 COUNTY ROAD 210 WSaint Johns, FL 32259
Mailing AddressPo Box 746638Atlanta, GA 30374-6638 · (904) 202-1032 · Fax (904) 376-4107
Phone(904) 824-4407
Fax(904) 390-7459
Sole ProprietorYes
Medical School CMSLake Erie College Of Osteopathic Medicine, ErieGraduated 2020
Enumeration DateJune 9, 2020
Last NPPES UpdateAugust 15, 20233 updates tracked since enumeration
NPPES CertifiedAugust 11, 2023
✔ NPI 1114542859 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in FL · OS18963
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1310 COUNTY ROAD 210 W, Saint Johns, FL 32259
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Secondary Practice Location 1

Location 114540 Old Saint Augustine Rd Ste 2317Jacksonville, FL 32258-7418 · Phone (904) 824-4407 · Fax (904) 390-7459

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).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

Olivia Michelle Bullock Do 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 ID6709208903
PECOS Enrollment IDI20230615000673
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 10

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 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.
287 services138 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
121 services95 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.
98 services98 patients
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.
54 services42 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
49 services49 patients
Annual alcohol misuse screening, 5 to 15 minutes G0442
An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.
25 services25 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100088
Location800 Prudential DrJacksonville, FL 32207 · Duval County
Emergency services Birthing friendly

Baptist Medical Center Beaches

Acute Care Hospitals · Jacksonville Beach, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100117
Location1350 13th Ave SJacksonville Beach, FL 32250 · Duval County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32259 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

91.62/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality77.61
Promoting Interoperability100
Improvement Activities40

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.

MARY STEPHENS MATHIS PA-C
Physician Assistant
1310 COUNTY ROAD 210 W
SAINT JOHNS, FL 32259
St. Johns County (904) 824-4407
DR. MATTHEW RYAN DEBOER DO
Family Medicine
1310 COUNTY ROAD 210 W
SAINT JOHNS, FL 32259
St. Johns County (904) 824-4407
DR. ANA MARIA ROMERO M.D.
Family Medicine
1310 COUNTY ROAD 210 W
SAINT JOHNS, FL 32259
St. Johns County (904) 824-4407
LEAH M ROSE APRN
Nurse Practitioner
1310 COUNTY ROAD 210 W
SAINT JOHNS, FL 32259
St. Johns County (904) 824-4407
BAPTIST PRIMARY CARE INC
Family Medicine
1310 COUNTY ROAD 210 W
ST. JOHNS, FL 32259
St. Johns County (904) 824-4407
JASON WAYNE LARGEN M.D.
Family Medicine
1310 COUNTY ROAD 210 W
ST JOHNS, FL 32259
St. Johns County (904) 824-4407
DR. TONY L. WILLSON MD
Family Medicine
1310 COUNTY ROAD 210 W
ST JOHNS, FL 32259
St. Johns County (904) 824-4407

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 Olivia Bullock's NPI number?

The NPI number for Olivia Bullock is 1114542859. It was assigned to this individual provider in the NPPES registry on June 9, 2020.

Where is Olivia Bullock located?

Olivia Bullock practices at 1310 County Road 210 W, Saint Johns, FL 32259. The listed phone number is (904) 824-4407.

What is Olivia Bullock's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Olivia Bullock enrolled in Medicare?

Yes. Olivia 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 Olivia Bullock accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Olivia 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.

Is Olivia Bullock affiliated with any hospitals?

According to CMS data, Olivia Bullock is affiliated with Baptist Health Medical Center - Jacksonville and Baptist Medical Center Beaches.

When was this NPI record last updated?

The NPPES record for Olivia Bullock was last updated on August 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.