MS. LUCILYN ANN BULLOCK PA-C
NPI 1104963552
Physician Assistant - Medical in Tallmadge, OH
NPI Status: Active since February 01, 2007
Contact Information
60 NORTH AVE
TALLMADGE, OH
ZIP 44278
Phone: (330) 670-4242
Fax: (330) 670-4241
- Individual
- Female
- Years of Experience 17
- Physician Assistant
- Medical
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About LUCILYN BULLOCK
This page provides the complete NPI Profile along with additional information for Lucilyn Bullock, a primary care provider established in Tallmadge, Ohio with a medical specialization in Physician Assistant, focusing in medical and more than 17 years of experience. The healthcare provider is registered in the NPI registry with number 1104963552 assigned on February 2007. The practitioner's primary taxonomy code is 363AM0700X with license number 50-000779 (OH). The provider is registered as an individual and her NPI record was last updated 3 years ago.
- NPI
- 1104963552
- Provider Name
- MS. LUCILYN ANN BULLOCK PA-C
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 60 NORTH AVE TALLMADGE, OH 44278
- Location Phone
- (330) 670-4242
- Location Fax
- (330) 670-4241
- Mailing Address
- 60 NORTH AVE TALLMADGE, OH 44278
- Mailing Phone
- (330) 630-9726
- Mailing Fax
- (330) 670-4241
- Medical School Name
- OTHER
- Graduation Year
- 2009
- Is Sole Proprietor?
- No
- Enumeration Date
- 02-01-2007
- Last Update Date
- 03-30-2022
- Code Navigator
A primary care provider (PCP) like Lucilyn Bullock sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Medical
- Taxonomy Code
- 363AM0700X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 50-000779
- License State
- OH
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision - HMO
- Anthem Bronze Pathway HMO 7450 for HSA - HMO
- Anthem Bronze Pathway HMO 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway HMO 9200 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway HMO 9200 Adult Dental & Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Catastrophic Pathway HMO 9200 - HMO
- Anthem Gold Pathway HMO 1500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Bronze Pathway HMO 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Silver Pathway X HMO 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway HMO 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway HMO 5000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway HMO 5400 for HSA - HMO
- Anthem Silver Pathway X HMO 4000 ($0 Virtual PCP + $0 Select Drugs) - HMO
- AultCare Bronze 5500 - PPO
- AultCare Bronze 7050 - PPO
- AultCare Gold 1000 - PPO
- AultCare Gold 1200 - PPO
- AultCare Gold 1800 - PPO
- AultCare Gold 2850 - PPO
- AultCare Gold 3150 - PPO
- AultCare Platinum 1200 - PPO
- AultCare Platinum 1800 Health Savings 500 - PPO
- AultCare Platinum 300 - PPO
- AultCare Platinum 500 - PPO
- AultCare Silver 2550 - PPO
- AultCare Silver 3000 - PPO
- AultCare Silver 4300 - PPO
- AultCare Silver 5100 - PPO
- AultCare Silver 6450 - PPO
- Bronze $8,300 w/ Virtual & Wellness ON-EX - HMO
- Bronze HSA $7,300 ON-EX - HMO
- Bronze Standard w/ Virtual & Wellness - HMO
- Gold $1250 w/ Virtual & Wellness ON-EX - HMO
- Gold $500 w/ Virtual & Wellness ON-EX - HMO
- Gold Standard w/ Virtual & Wellness - HMO
- Silver $5000 w/ Virtual & Wellness ON-EX - HMO
- Silver Standard w/ Virtual & Wellness - HMO
- SilverSelect w/ Virtual & Wellness ON-EX - HMO
- Young Adult Essentials ON-EX - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - HMO
- UHC Bronze Value ($5 Tier 2 Rx, No Referrals) - HMO
- UHC Bronze Value+ ($5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage ($3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage+ ($3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Gold Standard+ (Dental + Vision, No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
- UHC Silver Standard+ (Dental + Vision, No Referrals) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Lucilyn Bullock is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Lucilyn Bullock is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 6507921756
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20090223000283
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Administration of influenza virus vaccine
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Hemoglobin a1c level
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
This service was performed 15 times for 15 patientsAn annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
This service was performed 56 times for 56 patientsAn annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.
This service was performed 17 times for 17 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 47 times for 45 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 47 times for 38 patientsHemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
This service was performed 14 times for 12 patientsQuality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
Quality Measure | Performance | Number of Patients |
---|---|---|
Care Plan | 4% | 138 |
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
Colorectal Cancer Screening | 37% | 114 |
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
Pneumococcal Vaccination Status for Older Adults | 62% | 154 |
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 82% | 170 |
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
Screening for Osteoporosis for Women Aged 65-85 Years of Age | 28% | 75 |
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis |
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Lucilyn Bullock is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
SUMMA HEALTH SYSTEM | 525 EAST MARKET STREET AKRON, OH 44309 | (330) 375-3000 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 1 | 0 | 4 | 9 | 6 | 3 | 5 | 5 | 2 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 1 | 0 | 4 | 18 | 6 | 6 | 5 | 10 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 1 + 0 + 4 + 1 + 8 + 6 + 6 + 5 + 1 + 0 + 24 = 58 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 58 = 2 | 2 |
The NPI number 1104963552 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1518276260 | SUMMA PHYSICIANS INC Organization | Orthopaedic Surgery | 60 NORTH AVE TALLMADGE, OH 44278 (330) 865-5333 |
1801058631 | SUMMA PHYSICIANS INC Organization | Family Medicine | 60 NORTH AVE TALLMADGE, OH 44278 (330) 630-9726 |
1073101192 | BRANDI PODBOY Individual | Physician Assistant | 60 NORTH AVE TALLMADGE, OH 44278 (330) 630-9726 |
1013437284 | ELIZABETH JOY BEVINGTON MD Individual | Family Medicine | 60 NORTH AVE TALLMADGE, OH 44278 (330) 630-9726 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104963552, enumerated in the NPI registry as an "individual" on February 01, 2007
The provider is located at 60 North Ave Tallmadge, Oh 44278 and the phone number is (330) 670-4242
The provider's speciality is Physician Assistant with taxonomy code 363AM0700X with a focus in Medical
The provider has more than 17 years of experience.
The provider might be accepting Accepts: Aetna CVS Health, Anthem Blue Cross and Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
The most common procedures or services performed by this practitioner are: Administration of influenza virus vaccine, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit, Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes and Hemoglobin a1c level.
The practitioner is affiliated to the following hospital(s): SUMMA HEALTH SYSTEM. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on February 01, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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