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MATTHEW BROOKS BULKLEY MD
NPI 1205630100
Student in an Organized Health Care Education/Training Program in Livonia, MI

Active since April 02, 2025PECOS Enrolled
19000 ST JOES PKWY STE 310, LIVONIA, MI 48152(734) 743-4540 Get Directions Write a Review

NPPES record last updated: April 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Matthew Brooks Bulkley Md NPPES

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

MATTHEW BROOKS BULKLEY MD (NPI 1205630100) is an individual student in an organized health care education/training program in Livonia, Michigan and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205630100
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMATTHEW BROOKS BULKLEYCredential: MD
Location Address19000 ST JOES PKWY STE 310Livonia, MI 48152-1477
Mailing Address391 N Vineyard Ridge DrSt George, UT 84770-1348 · (435) 429-9930
Phone(734) 743-4540
Sole ProprietorNo
Enumeration DateApril 2, 2025
NPPES CertifiedApril 1, 2025
✔ NPI 1205630100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
19000 ST JOES PKWY STE 310, Livonia, MI 48152
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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)

Matthew Brooks Bulkley Md 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.

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.

RICHARD GERARD LEWANDOWSKI JR. DO
Student in an Organized Health Care Education/Training Program
19000 ST JOES PKWY STE 310
LIVONIA, MI 48152
Wayne County (734) 743-4540
DR. ELENI BILLS DO
Student in an Organized Health Care Education/Training Program
19000 ST JOES PKWY STE 310
LIVONIA, MI 48152
Wayne County (734) 743-4540
HANNAH SMITH MD
Student in an Organized Health Care Education/Training Program
19000 ST JOES PKWY STE 310
LIVONIA, MI 48152
Wayne County (734) 743-4540
RACHEL KLISZ
Social Worker
19000 ST JOES PKWY STE 310
LIVONIA, MI 48152
Wayne County (734) 743-4540
BENEDICT JOHN FREDERICK IV
Student in an Organized Health Care Education/Training Program
19000 ST JOES PKWY STE 310
LIVONIA, MI 48152
Wayne County (734) 743-4540
ISABELLA ANTON MD
Student in an Organized Health Care Education/Training Program
19000 ST JOES PKWY STE 310
LIVONIA, MI 48152
Wayne County (734) 743-4540
DR. NICHOLAS HOLLON DO
Psychiatry & Neurology (Psychiatry)
19000 ST JOES PKWY STE 310
LIVONIA, MI 48152
Wayne County (734) 743-4540
MICHAEL KAIN
Student in an Organized Health Care Education/Training Program
19000 ST JOES PKWY STE 310
LIVONIA, MI 48152
Wayne County (734) 743-4540

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 Matthew Bulkley's NPI number?

The NPI number for Matthew Bulkley is 1205630100. It was assigned to this individual provider in the NPPES registry on April 2, 2025.

Where is Matthew Bulkley located?

Matthew Bulkley practices at 19000 St Joes Pkwy Ste 310, Livonia, MI 48152. The listed phone number is (734) 743-4540.

What is Matthew Bulkley's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Matthew Bulkley enrolled in Medicare?

Yes. Matthew Bulkley is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Matthew Bulkley was last updated on April 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.