DR. DANIELLE RENEE BULLOCK M.D.
NPI 1730471293
Pediatrics in Minneapolis, MN

Q: What is Danielle Bullock's NPI number?

The NPI number for Danielle Bullock is 1730471293. It was assigned to this individual provider in the NPPES registry on May 3, 2011. The provider is also known as Dr. Danielle Renee Brueck.

Q: What is Danielle Bullock's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Danielle Bullock was last updated on July 5, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 May 03, 2011PECOS Enrolled

2450 RIVERSIDE AVE, M663 EAST BUILDING, MINNEAPOLIS, MN 55454(612) 626-4598(612) 626-6905 Get Directions Write a Review

NPPES record last updated: July 5, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 5, 2017, Jan 19, 2016 (2 updates tracked since 2016).

On this page

About Dr. Danielle Renee Bullock M.d. NPPES

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

DR. DANIELLE RENEE BULLOCK M.D. (NPI 1730471293) is an individual pediatrics provider in Minneapolis, Minnesota, licensed in Minnesota (57986) and active in the NPI registry since May 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1730471293

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. DANIELLE RENEE BULLOCKCredential: M.D.

Location Address2450 RIVERSIDE AVE, M663 EAST BUILDINGMinneapolis, MN 55454-1450

Mailing Address2450 Riverside Ave, M663 East BuildingMinneapolis, MN 55454-1450 · (612) 626-4598 · Fax (612) 626-6905

Phone(612) 626-4598

Fax(612) 626-6905

Sole ProprietorYes

Enumeration DateMay 3, 2011

Last NPPES UpdateJuly 5, 20172 updates tracked since enumeration

✔ NPI 1730471293 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in MN · 57986

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

2450 RIVERSIDE AVE, Minneapolis, MN 55454

Open in Google Maps ↗

Other Names 1

Former Name (1)Dr. Danielle Renee Brueck

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.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. Danielle Renee Bullock M.d. 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 Danielle Bullock reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Express Care

Same address

Clinic/Center

2450 RIVERSIDE AVE, STE F140
Minneapolis, MN 55454

Reassigned Medicare billing, Minnesota enrollment
3,633 clinicians in this Medicare group

NPI 1841428745 (612) 672-6999

Fairview Specialty Services

Same address

Physical Therapy

2450 RIVERSIDE AVE
Minneapolis, MN 55454

Reassigned Medicare billing, Minnesota enrollment
2,373 clinicians in this Medicare group

NPI 1043199334 (855) 324-7843

University Of Minnesota Pediatric Dental Clinic

0.1 mi

Dentist

701 25TH AVE S, SUITE 400
Minneapolis, MN 55454

Reassigned Medicare billing, Minnesota enrollment
Medicare enrollment name: University Of Minnesota Physicians
1,453 clinicians in this Medicare group

NPI 1992075287 (651) 659-4900

University Of Minnesota Health Clinics And Surgery Center Inc

0.7 mi

Anesthesiology

909 FULTON ST SE
Minneapolis, MN 55455

Reassigned Medicare billing, Minnesota enrollment
1,662 clinicians in this Medicare group

NPI 1003485004 (612) 273-8383

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 55454 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

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.

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.

MICHELLE IRENE GRAY

Rehabilitation Practitioner