MS. LUCILYN ANN BULLOCK (PA-C) – Medical Physician Assistant, NPI 1104963552
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,036 PHYSICIAN ASSISTANT in OH
Provider Addresses for MS. LUCILYN ANN BULLOCK (PA-C)
60 NORTH AVE
TALLMADGE, OH 442782011
Phone: (330) 670-4242
Fax: (330) 670-4241
Type: Location
3975, Embassy Parkway, Embassy Corporate Park, Bath Township, Summit County, Ohio, 44333, United States
SUITE 003
FAIRLAWN, OH 443338320
Phone: (330) 670-4242
Fax: (330) 670-4241
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 43 Open Payments records for all available years, with a total value of $995.
Total Amount is formed as General ($995) + Research ($0) + Ownership ($0) = $995.
Last reported payment date: 2024-07-24 • Largest payer in this snapshot: Novo Nordisk Inc ($146).
Total Amount
$995
General + Research + Ownership
Payments
43
Total payment records
General Amount
$995
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $146 |
| Lilly USA, LLC | $139 |
| ABBVIE INC. | $94 |
| Astellas Pharma US Inc | $85 |
| GlaxoSmithKline, LLC. | $57 |
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: 2009-02-23
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20090223000283 | I | Physician Assistant | OH | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 71 | 63 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 49 | 49 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 47 | 37 | $0 |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 13 | 13 | $0 |
| G0008 | Administration of influenza virus vaccine | 13 | 13 | $0 |
Insurance plans in this area (ZIP 44278)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | OH | |
| Family Practice | OH | |
| Pediatric Medicine, Internal Medicine | OH | |
| - | OH | |
| Internal Medicine | OH | |
| Nurse Practitioner | MN | |
| - | OH | |
| - | OH | |
| Nurse Practitioner | OH | |
| Internal Medicine, Pediatric Medicine | OH |
Reviews
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