DR. KENT BULLIS MD
NPI 1710079736
Family Medicine - Adolescent Medicine in Ithaca, NY
About Dr. Kent Bullis Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KENT BULLIS MD (NPI 1710079736) is an individual adolescent medicine provider in Ithaca, New York, licensed in Indiana (1034097) and active in the NPI registry since September 2006. He has opted out of Medicare through March 27, 2027 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Dr. Kent Bullis Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 27, 2017 through March 27, 2027.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 14853 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Kent Bullis's NPI number?
The NPI number for Kent Bullis is 1710079736. It was assigned to this individual provider in the NPPES registry on September 28, 2006.
Where is Kent Bullis located?
Kent Bullis practices at 110 Ho Plz, Ithaca, NY 14853. The listed phone number is (607) 255-5155.
What is Kent Bullis's specialty?
The primary specialty registered for this NPI is Family Medicine, specializing in Adolescent Medicine, with taxonomy code 207QA0000X.
Is Kent Bullis enrolled in Medicare?
No. Kent Bullis has opted out of Medicare through March 27, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
When was this NPI record last updated?
The NPPES record for Kent Bullis was last updated on September 26, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Dr. Kent Bullis, MD · NPI 1710079736
Adolescent Medicine physician in Ithaca, New York. Individual provider, active in the CMS NPPES registry since September 28, 2006.
## Identity
- **NPI:** 1710079736 (Entity type: Individual)
- **Enumerated:** September 28, 2006
- **Primary specialty:** Family Medicine - Adolescent Medicine · taxonomy 207QA0000X
- **State license:** 1034097 (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 110 HO PLZ, Ithaca, NY 14853-3102
- **Phone:** (607) 255-5155
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through March 27, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** September 26, 2013
- **Other identifiers:** Medicare UPIN D95444 (IN)
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Source: [NPI Profile](https://npiprofile.com/npi/1710079736) · Data from the CMS NPPES public registry.