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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KIMBERLEY ADAIRE BULLARD
NPI 1144856170
Obstetrics & Gynecology in Santa Rosa, CA

Active since March 21, 2020PECOS Enrolled
401 BICENTENNIAL WAY, SANTA ROSA, CA 95403(707) 393-4187 Get Directions Write a Review

NPPES record last updated: June 24, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 11, 2023, Mar 23, 2020, Mar 21, 2020 (3 updates tracked since 2020).

About Kimberley Adaire Bullard NPPES

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

KIMBERLEY ADAIRE BULLARD (NPI 1144856170) is an individual obstetrics & gynecology provider in Santa Rosa, California, licensed in California (A208467) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1144856170
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameKIMBERLEY ADAIRE BULLARD
Location Address401 BICENTENNIAL WAYSanta Rosa, CA 95403-2149
Mailing Address401 Bicentennial WaySanta Rosa, CA 95403-2149 · (707) 393-4187
Phone(707) 393-4187
Sole ProprietorNo
Enumeration DateMarch 21, 2020
Last NPPES UpdateJune 24, 20263 updates tracked since enumeration
NPPES CertifiedJune 24, 2026
✔ NPI 1144856170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in CA · A208467
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
401 BICENTENNIAL WAY, Santa Rosa, CA 95403
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberley Adaire Bullard is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95403 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
$142.00 typical visit price
range $63.04 – $187.01
Typical copayment $35.50 (range $15.76 – $46.75)
Most-billed visit code 99204
Established Patient
$77.94 typical visit price
range $21.02 – $153.40
Typical copayment $19.48 (range $5.25 – $38.35)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

MS. JESSICA ANNE RUTLAND R.D.
Dietitian, Registered
401 BICENTENNIAL WAY
SANTA ROSA, CA 95403
Sonoma County (707) 393-4787
KURT FALKENBERG P.T.
Physical Therapist
401 BICENTENNIAL WAY, EAST BUILDING, SUITE 190
SANTA ROSA, CA 95403
Sonoma County (707) 571-3352
DELILAH PATTERSON CRNA
Nurse Anesthetist, Certified Registered
401 BICENTENNIAL WAY
SANTA ROSA, CA 95403
Sonoma County (707) 393-4616
KRISZTINA J. BALAZS MD
Pediatrics
401 BICENTENNIAL WAY
SANTA ROSA, CA 95403
Sonoma County (707) 571-4000
JOHN F. KUNKEL MD
Pathology (Anatomic Pathology)
401 BICENTENNIAL WAY
SANTA ROSA, CA 95403
Sonoma County (707) 571-4000
CRISTINA COREY SCHROEN LCSW
Social Worker (Clinical)
401 BICENTENNIAL WAY
SANTA ROSA, CA 95403
Sonoma County (707) 571-2536
JIE GIOK RAHARDJA PHARMD
Pharmacist
401 BICENTENNIAL WAY
SANTA ROSA, CA 95403
Sonoma County (707) 393-4652
CONOR WILLIAM BOWMAN PHARM.D.
Pharmacist
401 BICENTENNIAL WAY
SANTA ROSA, CA 95403
Sonoma County (818) 522-1238

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 Kimberley Bullard's NPI number?

The NPI number for Kimberley Bullard is 1144856170. It was assigned to this individual provider in the NPPES registry on March 21, 2020.

Where is Kimberley Bullard located?

Kimberley Bullard practices at 401 Bicentennial Way, Santa Rosa, CA 95403. The listed phone number is (707) 393-4187.

What is Kimberley Bullard's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Kimberley Bullard enrolled in Medicare?

Yes. Kimberley Bullard is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kimberley Bullard was last updated on June 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 52 days 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.