BRENNAN ULLOM APRN, FNP-C
NPI 1851104400
Nurse Practitioner - Family in Medford, OR

Q: What is Brennan Ullom's NPI number?

The NPI number for Brennan Ullom is 1851104400. It was assigned to this individual provider in the NPPES registry on January 28, 2025.

Q: What is Brennan Ullom's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Brennan Ullom was last updated on January 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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 January 28, 2025PECOS EnrolledAccepts Medicare Assignment

3156 STATE ST, MEDFORD, OR 97504(541) 773-9772(541) 773-1113 Get Directions Write a Review

NPPES record last updated: January 28, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Brennan Ullom Aprn, Fnp-c NPPES

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

BRENNAN ULLOM APRN, FNP-C (NPI 1851104400) is an individual family provider in Medford, Oregon, licensed in Oregon (10038862) and active in the NPI registry since January 2025. He is enrolled in Medicare PECOS, is affiliated with Asante Rogue Regional Medical Center, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1851104400

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameBRENNAN ULLOMCredential: APRN, FNP-C

Location Address3156 STATE STMedford, OR 97504-8450

Mailing Address3156 State StMedford, OR 97504-8450

Phone(541) 773-9772

Fax(541) 773-1113

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateJanuary 28, 2025

NPPES CertifiedJanuary 28, 2025

✔ NPI 1851104400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in OR · 10038862

Also ListedRegistered NurseTaxonomy 163W00000X · License 201905568RN (OR)

3156 STATE ST, Medford, OR 97504

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brennan Ullom Aprn, Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID143741835

PECOS Enrollment IDI20250311001121

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Asante Rogue Regional Medical Center

Acute Care Hospitals · Medford, OR

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380018

Location2825 E Barnett RoadMedford, OR 97504 · Jackson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97504 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

$84.82 typical visit price

range $54.96 – $166.64

Typical copayment $21.20 (range $13.74 – $41.66)

Most-billed visit code 99203

Established Patient

$97.16 typical visit price

range $17.68 – $136.19

Typical copayment $24.29 (range $4.42 – $34.04)

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.

DR. JOEL BRUCE KLEIN MD

Family Medicine