JESSICA ELAINE BULLOCK (NP) – Family Nurse Practitioner, NPI 1609262278

JESSICA ELAINE BULLOCK (NP) is a healthcare provider. based in Wailuku, Hawaii. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 2240 (HI). The NPI Number for JESSICA ELAINE BULLOCK (NP) is 1609262278

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA ELAINE BULLOCK (NP)
NPI
1609262278
Phone
(808) 871-7772
Address
1881 NANI ST
Enumeration Date
10 April 2015
Last Update Date
30 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8085003439
Graduation Year
2014 (12 years ago)
PAC ID
2163743527
Group Practice PAC ID
8820456825
Professional Enrollment ID
I20170829000793
Address ID
HI967321634KA33XXXAVEX301
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:11State licenses:2Digital endpointsOther names

5,301 NURSE PRACTITIONER in SC

Provider Addresses for JESSICA ELAINE BULLOCK (NP)

  • 1881 NANI ST

    WAILUKU, HI 967931811

    Phone: (808) 871-7772

    Type: Mailing

  • 50 CROSS PARK CT

    GREENVILLE, SC 296054263

    Phone: (864) 797-7035

    Type: Location

  • 33 LONO AVE STE 250

    KAHULUI, HI 967321634

    Phone: (808) 500-3439

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $70.

Total Amount is formed as General ($70) + Research ($0) + Ownership ($0) = $70.

Last reported payment date: 2024-08-01 • Largest payer in this snapshot: Medtronic, Inc. ($24).

Total Amount

$70

General + Research + Ownership

Payments

3

Total payment records

General Amount

$70

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-01

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-08-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170829000793INurse PractitionerHITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 96793)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8820456825View full group profile
NameSpecialtyState
Medical OncologyIN
Nurse PractitionerHI

Reviews

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Frequently asked questions

What number should I use to identify JESSICA ELAINE BULLOCK (NP) for billing?
Administrative and clinical systems typically use NPI 1609262278 for JESSICA ELAINE BULLOCK (NP).
Does the public listing show JESSICA ELAINE BULLOCK (NP) as active?
JESSICA ELAINE BULLOCK (NP)'s NPI record reflects an active status in NPPES.
What type of care does JESSICA ELAINE BULLOCK (NP) provide?
JESSICA ELAINE BULLOCK (NP)'s profile centers on Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to JESSICA ELAINE BULLOCK (NP)?
The directory associates JESSICA ELAINE BULLOCK (NP) with Wailuku, Hawaii. Check all listed addresses for suites or satellite offices.
Can I export JESSICA ELAINE BULLOCK (NP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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