MR. MICAIAH A BULLY
NPI 1255134672
Student in an Organized Health Care Education/Training Program in Cambridge, MA

Q: What is Micaiah Bully's NPI number?

The NPI number for Micaiah Bully is 1255134672. It was assigned to this individual provider in the NPPES registry on March 31, 2025.

Q: What is Micaiah Bully's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Micaiah Bully was last updated on March 31, 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.

Active since March 31, 2025PECOS Enrolled

330 MOUNT AUBURN ST, CAMBRIDGE, MA 02138(617) 492-3500 Get Directions Write a Review

NPPES record last updated: March 31, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mr. Micaiah A Bully NPPES

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

MR. MICAIAH A BULLY (NPI 1255134672) is an individual student in an organized health care education/training program in Cambridge, Massachusetts and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255134672

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMR. MICAIAH A BULLY

Location Address330 MOUNT AUBURN STCambridge, MA 02138-5502

Mailing Address330 Mount Auburn StCambridge, MA 02138-5502 · (617) 492-3500

Phone(617) 492-3500

Sole ProprietorNo

Enumeration DateMarch 31, 2025

NPPES CertifiedMarch 26, 2025

✔ NPI 1255134672 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.

330 MOUNT AUBURN ST, Cambridge, MA 02138

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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)

Mr. Micaiah A Bully 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.

MR. MIGUEL ANGEL PAZ PA-C

Physician Assistant (Surgical)

330 MOUNT AUBURN ST
CAMBRIDGE, MA 02138

Middlesex County (617) 499-3500

DR. ALAAELDIN AHMED MD

Student in an Organized Health Care Education/Training Program

330 MOUNT AUBURN ST
CAMBRIDGE, MA 02138

Middlesex County (617) 492-3500

DR. JANE R. SHARP MD

Obstetrics & Gynecology

330 MOUNT AUBURN ST
CAMBRIDGE, MA 02138

Middlesex County (617) 499-5151

DR. LAURA NEED MD

Pediatrics (Pediatric Cardiology)

330 MOUNT AUBURN ST, NEWBORN SERVICES
CAMBRIDGE, MA 02138

Middlesex County (617) 499-5595

DR. VALERIE PRONIO-STELLUTO MD

Internal Medicine

330 MOUNT AUBURN ST
CAMBRIDGE, MA 02138

Middlesex County (617) 499-5140

DR. BENJAMIN KERMAN MD

Emergency Medicine

330 MOUNT AUBURN ST
CAMBRIDGE, MA 02138

Middlesex County (617) 499-5025

ANAESTHESIA ASSOCIATES OF MASSACHUSETTS, PC

Anesthesiology

330 MOUNT AUBURN ST
CAMBRIDGE, MA 02138

Middlesex County (617) 499-5075

PAVLINA CHRYSAFI

Student in an Organized Health Care Education/Training Program

330 MOUNT AUBURN ST
CAMBRIDGE, MA 02138

Middlesex County (617) 492-3500

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 Micaiah Bully's NPI number?

The NPI number for Micaiah Bully is 1255134672. It was assigned to this individual provider in the NPPES registry on March 31, 2025.

Where is Micaiah Bully located?

Micaiah Bully practices at 330 Mount Auburn St, Cambridge, MA 02138. The listed phone number is (617) 492-3500.

What is Micaiah Bully's specialty?

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

Is Micaiah Bully enrolled in Medicare?

Yes. Micaiah Bully is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Micaiah Bully was last updated on March 31, 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.