DR. STACY SUZANNE BULL MD
NPI 1619071115
Family Medicine - Sports Medicine in East Lansing, MI

Q: What is Stacy Bull's NPI number?

The NPI number for Stacy Bull is 1619071115. It was assigned to this individual provider in the NPPES registry on September 13, 2006. The provider is also known as Dr. Stacy Suzanne Ducklow MD.

Q: What is Stacy Bull's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Q: When was this NPI record last updated?

The NPPES record for Stacy Bull was last updated on September 7, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since September 13, 2006PECOS Enrolled

463 E CIRCLE DR, EAST LANSING, MI 48824(517) 884-6502(517) 355-9265 Get Directions Write a Review

NPPES record last updated: September 7, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 7, 2018, Jun 14, 2016 (2 updates tracked since 2016).

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About Dr. Stacy Suzanne Bull Md NPPES

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

DR. STACY SUZANNE BULL MD (NPI 1619071115) is an individual sports medicine provider in East Lansing, Michigan, licensed in Michigan (4301070974) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619071115

Entity TypeIndividualFemale

Primary Taxonomy207QS0010X

Provider Legal NameDR. STACY SUZANNE BULLCredential: MD

Location Address463 E CIRCLE DREast Lansing, MI 48824-7500

Mailing Address804 Service Rd, # A109fEast Lansing, MI 48824-7015 · (517) 884-2976 · Fax (517) 432-3928

Phone(517) 884-6502

Fax(517) 355-9265

Sole ProprietorNo

Enumeration DateSeptember 13, 2006

Last NPPES UpdateSeptember 7, 20182 updates tracked since enumeration

✔ NPI 1619071115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

License✔ Licensed in MI · 4301070974

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

463 E CIRCLE DR, East Lansing, MI 48824

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Other Names 1

Former Name (1)Dr. Stacy Suzanne Ducklow Md

Other Identifiers 3

Medicaid1619071115MI

Other0803310501MI · Bcbs Individual Pin

Medicaid4546883MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Stacy Suzanne Bull 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.

Medicare Billing Reassignments

Medicare enrollment records show Stacy Bull reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Board Of Trustees Of Michigan State University

0.3 mi

Clinical Medical Laboratory

463 E CIRCLE DR
East Lansing, MI 48824

Reassigned Medicare billing, Michigan enrollment
Medicare enrollment name: Michigan State University
14 clinicians in this Medicare group

NPI 1144309642 (517) 355-8237

Edward W Sparrow Hospital Association

0.6 mi

Cardiovascular Disease

1140 E MICHIGAN AVE STE 400
Lansing, MI 48912

Reassigned Medicare billing, Michigan enrollment
916 clinicians in this Medicare group

NPI 1245737402 (517) 364-9650

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48824 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

Reported Quality Measures

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

94%1,271 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

11%220 patients1/55-star benchmark: 88%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

100%538 patients5/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

32%2,085 patients2/55-star benchmark: 97%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

100%2,085 patients5/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

57%2,085 patients3/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

75%2,085 patients

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 20

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

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